Individual
ANNA RUTH DITESHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
LCSW-A
Contact information
Practice address
620 W LANE ST STE 202, RALEIGH, NC 27603-1441
(704) 650-4777
Mailing address
1051 SHORESIDE DR, DURHAM, NC 27713-5507
(704) 650-4777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P020748
NC
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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