Individual
CHASE ROBERT DIECKHONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
195 W SCHROCK RD, WESTERVILLE, OH 43081-2890
(614) 355-7570
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
08/31/2020
Last updated
08/31/2020
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