Individual
REBECCA DIETTERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1172 W MAIN ST # B, STROUDSBURG, PA 18360-1323
(570) 424-6187
Mailing address
1172 W MAIN ST # B, STROUDSBURG, PA 18360-1323
(570) 424-6187
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP027912
PA
Other
Enumeration date
08/15/2023
Last updated
04/24/2024
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