Individual
KIERSTEN DIETERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29691 6 MILE RD, LIVONIA, MI 48152-8606
(847) 562-6854
Mailing address
29691 6 MILE RD STE 100D, LIVONIA, MI 48152-8606
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001762
MI
Other
Enumeration date
11/14/2017
Last updated
02/16/2026
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