Individual
MR. CHARLES EDWARD DIETZEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 HANCOCK AVE, HIRAM, ME 04041
(207) 625-8947
Mailing address
36 HANDCOC AVE., HIRAM, ME 04041
(207) 625-8947
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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