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1477833762
JAIME DIETZEN
BENTONVILLE, AR
NPI
1477833762
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TX 60577)
Enumeration Date
2011-08-18
Last Update Date
2021-07-13
Business Address
Mrs. JAIME DIETZEN LCSW
2003 SE WALTON BLVD
BENTONVILLE, AR 72712-3725
Phone number: 479-464-5925
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Mailing Address
Mrs. JAIME DIETZEN LCSW
2458 SISKIYOU ST
LEWISVILLE, TX 75056-6790
Phone number: 972-743-4416
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