Individual
LESLIE DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504-2382
(928) 729-8000
Mailing address
PO BOX 2382, FORT DEFIANCE, AZ 86504-2382
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 60362969
WA
Other
Enumeration date
06/21/2013
Last updated
06/21/2013
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