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Individual

BRITTANY N DIETRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
118 MEDICAL DR, CARMEL, IN 46032-2923
(317) 573-1037
Mailing address
118 MEDICAL DR, CARMEL, IN 46032-2923
(317) 573-1037

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005840A
IN
235Z00000X
Speech-Language Pathologist
Primary
46002385A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22005840A
SLP STATE LICENSE NUMBER
IN
Enumeration date
09/18/2012
Last updated
04/30/2021
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