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Individual

MRS. ANDREA DIETSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(419) 376-7217
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
S 1302931
OH
1041C0700X
Clinical Social Worker
Primary
I.1700233
OH
1041S0200X
School Social Worker
S 1302931
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2871101
OH
Enumeration date
10/14/2014
Last updated
04/05/2017
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