SearchMaryland101YP2500X

Justin Deitrick, LGPC

NPI 1417660663 · on the registry since 2023

Practice

Address
3700 Championship Dr
Glenwood, MD 21738
Phone
(443) 472-1349

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Also registered as
101YS0200X
Licence states on file
MD
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-01-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland