Petrovich, Brian Dion

Petrovich, Brian Dion is an individual health care provider with primary practice located at 1186 E 4600 S , Ogden UT 84403-4332. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Petrovich, Brian Dion can be contacted via phone (801) 505-6545.

Contact Information

Primary practice address
1186 E 4600 S Ogden UT 84403-4332
Phone: (801) 505-6545
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2004017583 Missouri

Profile Details

NPI number 1336110568
LBN Legal business name Petrovich, Brian Dion
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated May 16th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336110568 NPPES
Missouri MEDICAID 494703309

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