Individual provider · Type 1 NPI

Heather Marie Diederich

Mental Health Counselor · San Luis Obispo, CA

NPI number 1366779522 Active

Practice location

277 South St, Ste. Y
San Luis Obispo, CA 93401-5039

Mailing address

PO Box 15408
San Luis Obispo, CA 93406-5408

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1366779522

Heather Marie Diederich's National Provider Identifier is 1366779522, issued on Nov 9, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Luis Obispo, CA. The record was last updated on Nov 9, 2009.