Heidi Dawn Dietl

NPI #1780201921 in Woodbury, New York

Provider Information

NPI Number: 1780201921
Entity Type: Individual
Name: Heidi Dawn Dietl
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Jul 4, 2020
Last Updated: Jul 4, 2020

Practice Location

Address: 234 CROSSWAYS PARK DR
City: Woodbury
State: New York
ZIP Code: 11797-2015
Phone: (516) 477-8003

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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