Individual
GEORGIANN LYNN DIETEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
960 WEST MAPLE COURT, ELMA, NY 14059
(716) 805-1555
(716) 805-1444
Mailing address
345 COUNTRYSIDE LN, APARTMENT 5, ORCHARD PARK, NY 14127-1339
(716) 574-7183
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0134411
NY
Other
Enumeration date
02/07/2007
Last updated
10/14/2009
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