Individual
MISS JENNIFER LYNNE DIETTERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
661 E DELL RD, BATH, PA 18014-9647
(610) 759-8825
Mailing address
661 E DELL RD, BATH, PA 18014-9647
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR003900200
NJ
225X00000X
Occupational Therapist
Primary
OC009694
PA
Other
Enumeration date
05/20/2007
Last updated
07/08/2007
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