Individual
JERA DILTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 N HUDSON ST, ALTUS, OK 73521-3811
(580) 379-4085
(580) 379-4062
Mailing address
111 N HUDSON ST, ALTUS, OK 73521-3811
(580) 379-4085
(580) 379-4062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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