Petchark, Mya
Petchark, Mya is an sole proprietor health care provider with primary practice located at 931 Bank St , New London CT 06320-2702. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Petchark, Mya can be contacted via phone (860) 574-8252.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1565 | Connecticut |
Profile Details
| NPI number | 1144069840 |
|---|---|
| LBN Legal business name | Petchark, Mya |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 22nd, 2024 |
| Last updated | May 22nd, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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