Individual
MRS. NINA G DIEDIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1615 PARKER AVE, OSAWATOMIE, KS 66064-1703
(913) 755-4165
(913) 755-3854
Mailing address
24408 W 391ST ST, FONTANA, KS 66026-7743
(913) 849-3598
(913) 755-3854
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-00873
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-00873
LICENSE
KS
Enumeration date
04/03/2007
Last updated
07/08/2007
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