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An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent and Children Mental Health |
261QM0855X | |||
Adult Mental Health |
261QM0850X |
| NPI Number | 1598217614 |
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| LBN Legal business name | SUSAN E DIETERICH PHD LLC | ||||
| Authorized official | SUSAN DIETERICH - (PSYCHOLOGIST) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/25/2016 | ||||
| Last updated | 10/25/2016 - About 10 years ago | ||||
| Identifiers |
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SUSAN E DIETERICH PHD LLC