Individual
CHANDI LOUISE DEITMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
77 4TH AVE STE 5, WALTHAM, MA 02451-7567
(781) 795-7252
Mailing address
19 CHANDLER ST APT 3, SOMERVILLE, MA 02144-1911
(201) 281-2350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
120004
MA
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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