Doctor Name: | LESLIE ANNE DIETER |
NPI Number: | 1184858748 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | DP02943368 |
Business Practice Address: | 224 E Liberty St Charles Town, WV - 254141824 |
Business Phone Number: | 5409312130 |
Business Fax Number: | |
Mailing Address: | 224 E Liberty St, CHARLES TOWN |
State: | WV |
Postal Code: | 254141824 |
Phone Number: | 5409312130 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2009 |
NPI Last Update Date: | 02/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | DP02943368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |