Individual
MS. JENNIFER DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
4801 SPRINGFIELD ST, DAYTON, OH 45431-1084
(937) 236-9965
(937) 233-0161
Mailing address
4801 SPRINGFIELD ST, DAYTON, OH 45431-1084
(937) 236-9965
(937) 233-0161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5989
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700074473
—
OH
Enumeration date
10/09/2007
Last updated
08/27/2015
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