Individual
BRAD S DIETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1425 STARR AVE, TOLEDO, OH 43605-2456
(419) 936-7600
(419) 936-7606
Mailing address
1425 STARR AVE, TOLEDO, OH 43605-2456
(419) 936-7600
(419) 936-7606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.2102532
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315253
—
OH
Enumeration date
09/20/2018
Last updated
11/10/2021
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