JACLYN DIETZOLD

PHILADELPHIA, PA
NPI1194138826
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA  MD470050)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA  MT207389)
Enumeration Date2014-06-10
Last Update Date2020-07-15
Business Address
Dr. JACLYN DIETZOLD M.D.
100 E LEHIGH AVE
PHILADELPHIA, PA 19125-1012
Phone number: 215-707-8496
Mailing Address
Dr. JACLYN DIETZOLD M.D.
2450 W HUNTING PARK AVE
PHILADELPHIA, PA 19129-1302
Phone number: 215-707-3411