Individual
CHRISTINE ANN DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1436 S LINCOLN ST, SHAWANO, WI 54166-3427
(715) 526-6111
Mailing address
918 S MAIN ST, SHAWANO, WI 54166-3262
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4598-027
WI
Other
Enumeration date
05/05/2008
Last updated
07/01/2025
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