| Doctor Name: | MRS. ROSALIND MACKRAZ DIETERICH |
| NPI Number: | 1033350723 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 6801090990 |
| Business Practice Address: | 2900 Packard Rd Suite 1 Ypsilanti, MI - 481972060 |
| Business Phone Number: | 7345289703 |
| Business Fax Number: | 7345728866 |
| Mailing Address: | 1618 Briar Ridge Dr, ANN ARBOR |
| State: | MI |
| Postal Code: | 481089400 |
| Phone Number: | 7346467297 |
| Fax Number: | 7346610116 |
| NPI Enumeration Date: | 03/10/2009 |
| NPI Last Update Date: | 03/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801090990 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |