NPI 1003190059

Fred J Petrilla Jr PHD & Associates PA

Organisation Clinical Psychologist Vero Beach, FL

Practice location

Address: 1903 25th St, Vero Beach, FL 32960-3366
Phone: (772) 562-0777
Fax: (772) 770-3285

Authorised official

Name: Fred J Petrilla
Title: President
Phone: (772) 562-0777

Registered specialties (2)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence PY0002507 (FL)

Other Psychologist providers in Florida →

School Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TS0200X Licence SS33 (FL)

Registry record

NPI: 1003190059
Entity type: Organization
NPI issued: 7 Oct 2011
Record last updated: 17 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.