Individual
MEGAN DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1226 CLEARVIEW DR, FLUSHING, MI 48433-1418
(269) 547-0527
Mailing address
1226 CLEARVIEW DR, FLUSHING, MI 48433-1418
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014012
MI
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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