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1982120358
KEITH PETTIFORD
WILMINGTON, DE
NPI
1982120358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-08-17
Last Update Date
2017-08-17
Business Address
KEITH PETTIFORD
2713 LANCASTER AVE
WILMINGTON, DE 19805-5220
Phone number: 302-225-2500
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Mailing Address
KEITH PETTIFORD
2713 LANCASTER AVE
WILMINGTON, DE 19805-5220
Phone number:
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