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Individual

DR. ZACHARY CLAYBORNE DIETRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
100 EXECUTIVE PARK STE 103, LOUISVILLE, KY 40207-4201
(502) 313-6880
Mailing address
910 HOWSER RD, HENRYVILLE, IN 47126-8616
(502) 807-2481

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
252672
KY

Other

Enumeration date
09/12/2019
Last updated
09/12/2019
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