DIANE DETTMORE

WAYNE, NJ
NPI1285045757
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NJ  26NJ00456900)
Enumeration Date2014-05-18
Last Update Date2014-05-18
Business Address
-- DIANE DETTMORE
1340 HAMBURG TPKE
WAYNE, NJ 07470-4003
Phone number: 973-633-1996
Mailing Address
-- DIANE DETTMORE
57 MONTROSS AVE
RUTHERFORD, NJ 07070-1147
Phone number: 551-206-9812
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