Individual
MR. JOHN DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1948 W BOULEVARD, KOKOMO, IN 46902-6078
(574) 727-1765
Mailing address
1948 W BOULEVARD, KOKOMO, IN 46902-6078
(574) 727-1765
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88002304A
IN
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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