Individual
DEIRDRE DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
T-LMLP
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Mailing address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
(913) 682-4664
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1432
KS
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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