Individual
HALEY MARIE DIEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
717 E ALFRED ST, WEYAUWEGA, WI 54983-9024
(920) 867-3121
Mailing address
717 E ALFRED ST, WEYAUWEGA, WI 54983-9024
(920) 867-3121
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4854-154
WI
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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