Chantel Dimitricoff

NPI #1407105398 in Logan, Utah

Provider Information

NPI Number: 1407105398
Entity Type: Individual
Name: Chantel Dimitricoff
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Sep 6, 2012
Last Updated: Sep 6, 2012

Practice Location

Address: 90 E 200 N
City: Logan
State: Utah
ZIP Code: 84321
Phone: (435) 752-0750

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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