SHAUN DIETERICH

HAUPPAUGE, NY
NPI1235400599
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: NY  004586)
Enumeration Date2012-01-18
Last Update Date2012-01-18
Business Address
MR. SHAUN DIETERICH LMHC
121 S PLAISTED AVE
HAUPPAUGE, NY 11788-2755
Phone number: 631-780-5828
Mailing Address
MR. SHAUN DIETERICH LMHC
121 S PLAISTED AVE
HAUPPAUGE, NY 11788-2755
Phone number: 631-780-5828
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