Individual
MRS. JANICE ELAINE DITERESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1025 ROBERT TELFORD DR, RICHMOND, KY 40475-1199
(812) 725-4744
Mailing address
672 NELLIE BAKER RD, MC KEE, KY 40447-8788
(812) 725-4744
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
173881
KY
225X00000X
Occupational Therapist
31000834A
IN
Other
Enumeration date
01/01/2017
Last updated
10/24/2020
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