Individual
AMY PETTENGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLADC
Contact information
Practice address
700 LAKE AVE, MANCHESTER, NH 03103-2734
(603) 622-3020
Mailing address
700 LAKE AVE STE A, MANCHESTER, NH 03103-2734
(603) 622-3020
(603) 622-8094
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0957
NH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1233
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3126041
—
NH
Enumeration date
05/02/2019
Last updated
06/24/2025
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