Individual
SHAWNA DAVELLA DIETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
D362765135841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D362765135841
IDENTIFICATION
MI
Enumeration date
02/27/2020
Last updated
02/27/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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