Individual
DR. SUSAN J RAUTIO-DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
532 N WALNUT ST, SUITE D, BLOOMINGTON, IN 47404-3809
(812) 332-7394
Mailing address
PO BOX 5185, BLOOMINGTON, IN 47407-5185
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040224A
IN
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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