Provider Demographics
NPI:1346992658
Name:ARTZ, PETRA (MPS, ATR-BC, LPC)
Entity Type:Individual
Prefix:
First Name:PETRA
Middle Name:
Last Name:ARTZ
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 SHACKAMAXON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3914
Mailing Address - Country:US
Mailing Address - Phone:215-327-4935
Mailing Address - Fax:
Practice Address - Street 1:600 HAVERFORD RD STE G101
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1139
Practice Address - Country:US
Practice Address - Phone:610-649-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty