Individual
DIEDRE LESLIE HOLTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-4627
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-4627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C014081
NC
Other
Enumeration date
06/03/2019
Last updated
08/23/2021
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