| NPI | 1396028528 |
|---|---|
| Former Name | COLIN M DIETZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 00000000A) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2023-01-07 |