person
Mr. Lisa Diane Dietz, MS
Mental Health Counselor in Ponca City, Oklahoma
NPI 1952438293

Lisa Diane Dietz is a Mental Health Counselor based in Ponca City, OK and is specialized in Mental Health. Lisa Diane Dietz practices in Ponca City, OK and has the professional credentials of MS. The NPI Number for Lisa Diane Dietz is 1952438293 and holds a License No. 1642 (Oklahoma).

The current practice location address for Lisa Diane Dietz is 222 E Grand Ave, Ponca City, OK and can be reached out via phone at 580-763-2256 and via fax at 580-762-6511. You can also correspond with Lisa Diane Dietz through the mailing address at 222 E GRAND AVE, PONCA CITY, OK - 74601-4316 (mailing address contact number: 580-763-2256).

Location: 222 E Grand Ave, Ponca City, OK, 74601-4316
person
Provider Profile Details
NPI Number
1952438293
Provider Name
Lisa Diane Dietz
Credential
MS
Provider Entity Type
Individual
Gender
Female
Address
222 E Grand Ave, Ponca City, OK, 74601-4316
Phone Number
580-763-2256
Fax Number
580-762-6511
Provider Enumeration Date
02/27/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
222 E Grand Ave
City
State
Zip
74601-4316
Phone Number
580-763-2256
Fax Number
580-762-6511
person
Provider Business Mailing Address Details
Address
222 E Grand Ave
City
State
Zip
74601-4316
Phone Number
580-763-2256
Fax Number
580-762-6511
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
1642 (Oklahoma)
Definition
Definition to come...
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