DR. Jacqueline Bernadine Petravage, M.D.
NPI #1104861079 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1104861079
- Entity Type
- Individual
- Name
- DR. Jacqueline Bernadine Petravage, M.D.
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Credential
- M.D.
- Enumeration Date
- Jun 17, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- VETERAN'S HOSPITAL, 500 FOOTHILL BLVD
- Address 2
- BLDG 47
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84148-0001
- Phone
- (801) 582-1565
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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