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Jackie Dietz

NPI 1881938397 · on the registry since 2012 · sole proprietor

Practice

Address: 640 3rd St
Gaylord, MN 55334
Phone: (507) 237-8730
Organisation at this address: Bayside Manor Llc
Gaylord Lakeview Home
Bayside Manor Assisted Living Llc
Oak Terrace Health Care Center Of Gaylord ,Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 14

Registry record

Primary taxonomy: Speech-Language Pathologist
235Z00000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-11-21

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 Minnesota