Individual
CORNELIA TIETKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5247 WISCONSIN AVE NW, SUITE 2, WASHINGTON, DC 20015-2012
(202) 271-5673
Mailing address
5247 WISCONSIN AVE NW STE 2, WASHINGTON, DC 20015-2012
(202) 271-5673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50079008
DC
Other
Enumeration date
04/19/2011
Last updated
04/12/2012
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