Individual
MRS. LAURA SUZANNE DIETSCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9393
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9393
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5296-26
WI
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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