Petkovich, Robin
Petkovich, Robin is an sole proprietor health care provider with primary practice located at 1700 W Smith Valley Rd Ste A8 , Greenwood IN 46142-1589. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Petkovich, Robin can be contacted via phone (317) 750-9797.Contact Information
Primary practice address
1700 W Smith Valley Rd Ste A8
Greenwood IN 46142-1589
Phone: (317) 750-9797
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041918 | Indiana |
Profile Details
| NPI number | 1144270422 |
|---|---|
| LBN Legal business name | Petkovich, Robin |
| Credentials | PHD, HSPP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2006 |
| Last updated | Dec 2nd, 2010 - about 15 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144270422 | NPPES |
| Indiana | MEDICAID | 200496030 |
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