Individual
MARCIA C DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25250 N 35TH AVE, PHOENIX, AZ 85083-4335
(623) 445-7100
(623) 445-7180
Mailing address
25250 N 35TH AVE, PHOENIX, AZ 85083-4335
(623) 445-7100
(623) 445-7180
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4074924
AZ
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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