LISA DIANE DIETZ

PONCA CITY, OK
NPI1952438293
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OK  1642)
Enumeration Date2007-02-27
Last Update Date2007-07-08
Business Address
Mr. LISA DIANE DIETZ M.S.
222 E GRAND AVE SUITE 404
PONCA CITY, OK 74601-4316
Phone number: 580-763-2256
Mailing Address
Mr. LISA DIANE DIETZ M.S.
222 E GRAND AVE SUITE 404
PONCA CITY, OK 74601-4316
Phone number: 580-763-2256