DOMINIQUE DIETZ

ALTON, IL
NPI1790325801
Former NameDOMINIQUE SHELPER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2020-01-07
Last Update Date2020-01-07
Business Address
DOMINIQUE DIETZ
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
Mailing Address
DOMINIQUE DIETZ
902 W MAIN ST
WEST FRANKFORT, IL 62896-2210
Phone number:
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