Individual
JUSTIN DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
2737 YOUNGSTOWN RD SE, WARREN, OH 44484-5002
(330) 369-8022
Mailing address
2737 YOUNGSTOWN RD SE, WARREN, OH 44484-5002
(330) 369-8022
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
174033
OH
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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