Dietrich, Debra
Dietrich, Debra is an sole proprietor health care provider with primary practice located at 2404 E Empire St , Bloomington IL 61704-3630. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Dietrich, Debra can be contacted via phone (309) 663-8275.Contact Information
Primary practice address
2404 E Empire St
Bloomington IL 61704-3630
Phone: (309) 663-8275
Fax: (309) 687-2035
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X | 1062455 | Illinois |
Profile Details
| NPI number | 1396947974 |
|---|---|
| LBN Legal business name | Dietrich, Debra |
| Credentials | PSYCHOLOGIST |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 5th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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