Individual
MS. JANET MARIE DIETERLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1039 RESERVOIR AVE, CRANSTON, RI 02910-5135
(401) 516-3742
Mailing address
78 MAPLE AVE, WEST WARWICK, RI 02893-4425
(401) 516-3742
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT01611
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT01611
DEPARTMENT OF HEALTH
RI
Enumeration date
12/05/2012
Last updated
12/05/2012
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