DEBRA DIETRICH

BLOOMINGTON, IL
NPI1396947974
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TS0200X Psychologist, School
(Licence: IL  1062455)
Enumeration Date2007-06-05
Last Update Date2007-07-08
Business Address
-- DEBRA DIETRICH Psychologist
2404 E EMPIRE ST
BLOOMINGTON, IL 61704-3630
Phone number: 309-663-8275
Mailing Address
-- DEBRA DIETRICH Psychologist
PO BOX 991
MORTON, IL 61550-0991
Phone number: 309-678-3155