Individual
ERIN DIEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
316 E 14TH ST, KAUKAUNA, WI 54130-3304
(920) 766-6020
Mailing address
W994 COUNTY ROAD JJ, KAUKAUNA, WI 54130-9639
(920) 759-0894
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2988
WI
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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