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1316369937
JUSTIN DAVID PETRUSAK
DETROIT, MI
NPI
1316369937
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801090356)
Enumeration Date
2014-01-16
Last Update Date
2016-03-08
Business Address
Mr. JUSTIN DAVID PETRUSAK LMSW
4756 CASS AVE
DETROIT, MI 48201-2357
Phone number: 313-577-4409
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Mailing Address
Mr. JUSTIN DAVID PETRUSAK LMSW
9428 MCDOUGALL ST FL 2
HAMTRAMCK, MI 48212-3564
Phone number: 586-214-4019
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