| Doctor Name: | DIANE V PETZ |
| NPI Number: | 1003978024 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., L.P. |
| License Number: | LP3132 |
| Business Practice Address: | 66 E 3rd St 201 Winona, MN - 559873478 |
| Business Phone Number: | 5074527292 |
| Business Fax Number: | 5074579887 |
| Mailing Address: | 66 E 3rd St, 201 WINONA |
| State: | MN |
| Postal Code: | 559873478 |
| Phone Number: | 5074527292 |
| Fax Number: | 5074579887 |
| NPI Enumeration Date: | 12/15/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP3132 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |