Individual
CAMILLE DIETERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 ALCAZAR ST, CSC-133, LOS ANGELES, CA 90089-0107
(323) 442-3340
Mailing address
2250 ALCAZAR ST, CSC-133, LOS ANGELES, CA 90089-0107
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 9873
CA
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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