| Provider / Organization | NPI | Date Certified |
|---|---|---|
| HEIDI DAWN DIETL | 1780201921 | 2020-07-04 |
Heidi Dawn Dietl is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1780201921. Registration indicates Heidi Dawn Dietl is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Massage Therapist (Massage Therapist, ) (Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Heidi Dawn Dietl |
| Practice Office Address | 234 CROSSWAYS PARK DR WOODBURY, NY US |
| Practice Office Telephone | 5164778003 |
| Mailing Address | 234 CROSSWAYS PARK DR WOODBURY, NY 117972015 US |
| Code | Practice | License No State |
|---|---|---|
| 225700000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist Massage Therapist Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 022165
NY |