Individual provider · Type 1 NPI

Jessica Dieteman, LMHC

Mental Health Counselor · Lackawanna, NY

NPI number 1043081367 Active

Practice location

790 Ridge Rd
Lackawanna, NY 14218-1629

Specialties and licenses

Taxonomy	Code	License
Mental Health Counselor Primary	101YM0800X	004561 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1043081367

Jessica Dieteman, LMHC's National Provider Identifier is 1043081367, issued on Jan 15, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lackawanna, NY. The record was last updated on Jan 15, 2024.