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Jacqueline Petrovic
Peer Specialist in Bend, Oregon
NPI 1760053086

Jacqueline Petrovic is a Peer Specialist based in Bend, OR. Jacqueline Petrovic practices in Bend, OR. The NPI Number for Jacqueline Petrovic is 1760053086 and holds a License No. (Oregon).

The current practice location address for Jacqueline Petrovic is 1900 Ne Division St Ste 201, Bend, OR and can be reached out via phone at 541-516-6330.

Location: 1900 Ne Division St Ste 201, Bend, OR, 97701-3572
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760053086
Provider Name
Jacqueline Petrovic
Credential
Provider Entity Type
Individual
Gender
Female
Address
1900 Ne Division St Ste 201, Bend, OR, 97701-3572
Phone Number
541-516-6330
Fax Number
Provider Enumeration Date
07/07/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1900 Ne Division St Ste 201
City
Bend
State
Oregon
Zip
97701-3572
Phone Number
541-516-6330
Fax Number
person
Provider Business Mailing Address Details
Address
1900 Ne Division St Ste 201
City
Bend
State
Oregon
Zip
97701-3572
Phone Number
541-516-6330
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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