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Individual

MR. ERIC ANTHONY GIETZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
93 ROLLING PARK DR N, MASSILLON, OH 44647-5196
(330) 617-7598
Mailing address
93 ROLLING PARK DRIVE NORTH, MASSILLON, OH 44647
(330) 617-7598

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
475186391
OH
Enumeration date
08/21/2017
Last updated
07/21/2022
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