Individual
NICOLE ELIZABETH DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-5958
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
089112
NY
104100000X
Social Worker
Primary
12869
SC
Other
Enumeration date
02/04/2020
Last updated
10/23/2020
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