Provider Information for 1982259032
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Mrs. PETRA DAJEVIC GROSS LPC
Other Names:Former Name:Ms. PETRA DAJEVIC MSSex: Female
NPI: 1982259032
Last Updated: 2021-11-20
Certification Date: 2021-11-20
Certification Date: 2021-11-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982259032 | ||||||||
| Enumeration Date | 2019-08-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 700 TECH CENTER PKWY STE 200-17 NEWPORT NEWS, VA 23606-3075 United States Phone: 757-690-1992 | Fax: | ||||||||
| Primary Practice Address | 700 TECH CENTER PKWY STE 200-17 NEWPORT NEWS, VA 23606-3075 United States Phone: 757-690-1992 | Fax: | ||||||||
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