Individual
ELLIZABETH ANN DIEDRICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 BRADFORD ST, STOUGHTON, MA 02072-2874
(781) 344-1364
Mailing address
31 BRADFORD ST, STOUGHTON, MA 02072-2874
(781) 344-1364
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7556
MA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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