Individual
TAMI GRAVEN DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSA
Contact information
Practice address
9719 ARAGORN LN NW, CHARLOTTE, NC 28269-6998
(704) 807-7545
Mailing address
9719 ARAGORN LN NW, CHARLOTTE, NC 28269-6998
(704) 807-7545
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C007510
NC
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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