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Individual

MRS. ADRIENNE KELLY DIETRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., ED.

Contact information

Practice address
18564 US ROUTE 11, SUITE 5, WATERTOWN, NY 13601-5900
(315) 786-7202
Mailing address
7289 RICE RD, LOWVILLE, NY 13367-9600
(315) 376-4208

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
06/06/2012
Last updated
06/06/2012
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