Individual
JENNA DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, CCC-SLP
Contact information
Practice address
4634 CORTEZ DR, QUINCY, IL 62305-4402
(217) 430-6865
Mailing address
4634 CORTEZ DR, QUINCY, IL 62305-4402
(217) 440-0898
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.007181
IL
Other
Enumeration date
09/19/2023
Last updated
06/24/2025
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