Individual
LESLIE ANNE DIETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 E LIBERTY ST, CHARLES TOWN, WV 25414-1824
(540) 931-2130
Mailing address
224 E LIBERTY ST, CHARLES TOWN, WV 25414-1824
(540) 931-2130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP02943368
WV
Other
Enumeration date
05/12/2009
Last updated
02/09/2015
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