Individual
CONNOR DANIEL HARMSEN DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S. SLPA
Contact information
Practice address
5980 RADIO STATION RD, LA PLATA, MD 20646-3337
(410) 212-0974
Mailing address
902 SAINT CLAIRE CT, ANNAPOLIS, MD 21409-5679
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
00156A
MD
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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