Individual
GRETCHEN DITTRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-2263
(774) 442-2270
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0005
MA
103TC0700X
Clinical Psychologist
0005
MA
Other
Enumeration date
11/11/2016
Last updated
11/11/2016
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