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1922492974
DAVID ALAN DIETRICK
NEW HAVEN, CT
NPI
1922492974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CT 004178)
Enumeration Date
2015-03-26
Last Update Date
2019-09-30
Business Address
Mr. DAVID ALAN DIETRICK APRN
184 LIBERTY ST
NEW HAVEN, CT 06519-1625
Phone number: 203-688-9791
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Mailing Address
Mr. DAVID ALAN DIETRICK APRN
1304 WEST ST
GUILFORD, CT 06437-1075
Phone number: 034-571-9662
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