Individual
KYLEIGH DIETTERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
759 SUSQUEHANNA TRL, WATSONTOWN, PA 17777-8109
(570) 428-9504
Mailing address
110 BUE JAY RD, MILLVILLE, PA 17846
(570) 380-0941
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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