MISS Braley Nichole Dietzen, MS, LPC

NPI #1386225415 in Newton, Illinois

Provider Information

NPI Number: 1386225415
Entity Type: Individual
Name: MISS Braley Nichole Dietzen, MS, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: MS, LPC
Enumeration Date: Apr 20, 2021
Last Updated: Apr 20, 2021

Practice Location

Address: 106 EDWARDS ST
City: Newton
State: Illinois
ZIP Code: 62448-1736
Phone: (618) 783-4154

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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