Individual
DIANE V PETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.P.
Contact information
Practice address
66 E 3RD ST, 201, WINONA, MN 55987-3478
(507) 452-7292
(507) 457-9887
Mailing address
66 E 3RD ST, 201, WINONA, MN 55987-3478
(507) 452-7292
(507) 457-9887
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3132
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118043
—
MN
01
—
731291024499
PREFERRED ONE
MN
01
—
975T0PE
BCBS-MN
MN
01
—
HP29923
HEALTHPARTNERS
MN
Enumeration date
12/15/2006
Last updated
07/09/2007
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