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1760787121
KELLY DIETZEN
GLENDALE, CA
NPI
1760787121
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
176B00000X Midwife
(Licence: CA 257)
Enumeration Date
2011-01-17
Last Update Date
2011-01-17
Business Address
-- KELLY DIETZEN LM
1327 CAMPBELL ST
GLENDALE, CA 91207-1446
Phone number: 323-240-4024
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Mailing Address
-- KELLY DIETZEN LM
1327 CAMPBELL ST
GLENDALE, CA 91207-1446
Phone number: 323-240-4024
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