Individual
MR. DIETRICH HENRY KULZE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.I.C.S.W.
Contact information
Practice address
165 QUINCY ST, BROCKTON, MA 02302-2988
(508) 897-2100
(508) 586-5117
Mailing address
96 CONCORD RD, BILLERICA, MA 01821-2516
(978) 663-5241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1027180
MA
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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