DIANE MARY PETTKO

PRINCE FREDERICK, MD
NPI1942694278
Former NameDIANE MARY FAUVER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2015-03-25
Last Update Date2022-11-29
Business Address
DIANE MARY PETTKO MS, LCADC
280 STAFFORD RD
PRINCE FREDERICK, MD 20678-3582
Phone number: 410-535-3079
Mailing Address
DIANE MARY PETTKO MS, LCADC
PO BOX 1158
PRINCE FREDERICK, MD 20678-1158
Phone number: 410-535-3079
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