Individual
CARLY DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC, MS
Contact information
Practice address
616 MAIN ST FL 4, HONESDALE, PA 18431-1871
(570) 504-2697
Mailing address
121 BACON ST APT B, JERMYN, PA 18433-1301
(484) 219-9305
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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