Individual
MS. ASHLEY DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2451 BASELINE RD, GRAND ISLAND, NY 14072-1657
(716) 773-8870
Mailing address
112 WEYAND AVE, BUFFALO, NY 14210-2371
(716) 308-2205
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010203-01
NY
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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