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Individual

TIFFANY DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2800 S SHIRLINGTON RD STE 102, ARLINGTON, VA 22206-3603
(703) 738-4336
Mailing address
11350 MCCORMICK RD, BUILDING 1, SUITE 501, HUNT VALLEY, MD 21031
(410) 329-1071
(410) 329-1054

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006117
VA

Other

Enumeration date
03/16/2018
Last updated
07/24/2019
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