Pettko, Diane Mary

Pettko, Diane Mary is an individual health care provider with primary practice located at 280 Stafford Rd , Prince Frederick MD 20678-3582. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Pettko, Diane Mary can be contacted via phone (410) 535-3079.

Contact Information

Primary practice address
280 Stafford Rd Prince Frederick MD 20678-3582
Phone: (410) 535-3079
Fax: (410) 535-2220
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1942694278
LBN Legal business name Pettko, Diane Mary
Credentials MS, LCADC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2015
Last updated Nov 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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