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1184207078
AUDREY DIETZ
TAHLEQUAH, OK
NPI
1184207078
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2021-04-29
Last Update Date
2021-04-29
Business Address
AUDREY DIETZ
472 S STATE AVE
TAHLEQUAH, OK 74464-4326
Phone number: 918-330-0671
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Mailing Address
AUDREY DIETZ
472 S STATE AVE
TAHLEQUAH, OK 74464-4326
Phone number: 918-330-0671
Copy
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