DEBRA DIETRICH (NPI# 1396947974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396947974 |
| Entity Type | Individual |
| Full Name | DEBRA DIETRICH |
| Credential | PSYCHOLOGIST |
| Practice Address |
2404 E Empire St Bloomington IL 61704-3630 |
| Mailing Address |
Po Box 991 Morton IL 61550-0991 |
| Practice Telephone | 3096638275 |
| Practice Fax Number | 3096872035 |
| Mailing Telephone | 3096783155 |
| Mailing Fax Number | 3096726717 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
1062455 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2404 E EMPIRE ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235785106 | Meghan Cotsones | Physical Therapist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2019-08-15 |
| 1851858880 | Michelle Lynn Bognanno | Speech-Language Pathologist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2019-02-26 |
| 1457817199 | Margaret Renee Jones | Social Worker | 2404 E Empire St, Bloomington, IL 61704-3630 | 2019-02-19 |
| 1386129864 | Hallie M Johnson | Behavioral Analyst | 2404 E Empire St, Bloomington, IL 61704-3630 | 2018-10-01 |
| 1336515022 | Amanda Gruber | Physical Therapist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2015-08-17 |
| 1033548367 | Jim Cooper | Developmental Therapist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2013-11-07 |
| 1134427669 | Easter Seals | Speech-Language Pathologist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2011-03-08 |
| 1801103528 | Erin Marlene Fabish | Speech-Language Pathologist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2010-09-01 |
| 1972734861 | Jamie J Fifarek | Physical Therapist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2009-07-27 |
| 1144492257 | Laurie Marie Jeans | Specialist | 2404 E Empire St, Bloomington, IL 61704-3630 | 2008-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1376747048 | Donald R. Weller | Psychologist | 1714 E Circle Dr, Bloomington, IN 47401-6028 | 2007-06-14 |
| 1619585973 | Poppi Stowe | Psychologist | 10435 Cedar Ave, Bloomington, CA 92316-2403 | 2020-07-22 |
| 1902414006 | Misha Graves | Psychologist | 482 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-07-15 |
| 1609023902 | Rose Anne Jackson | Psychologist | 631 N College Ave, Bloomington, IN 47404-3871 | 2008-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679428 | Jessica Scharf | Psychologist | 8502 Bailey Rd # 63, Darien, IL 60561-5333 | 2020-11-06 |
| 1225637283 | Nicole Maggard | Psychologist | 137 Somerset Rd, Willowbrook, IL 60527-5470 | 2020-10-21 |
| 1033724232 | Shadequia Davis | Psychologist | 402 Richards St, Joliet, IL 60433-2218 | 2020-09-14 |
| 1043823123 | Lindsay Ann Franklin | Psychologist | 436 Coral Dr, Morton, IL 61550-8505 | 2020-08-28 |
| 1053923995 | Annie Biehl | Psychologist | 9750 Soreng Ave, Schiller Park, IL 60176-2105 | 2020-08-21 |
| 1811508989 | Caroline Cook | Psychologist | 246 S Fair Ave, Elmhurst, IL 60126-3600 | 2020-08-12 |
| 1760009955 | Tammy Carroll | Psychologist | 3801 Lake Ct, Trenton, IL 62293-2938 | 2020-07-03 |
| 1316568629 | Denisa Kerekes | Psychologist | 1536 Cedarwood Ct, Gurnee, IL 60031-6346 | 2020-04-28 |
| 1740801174 | Jessica Berlinghof | Psychologist | 220 Greenwood Dr, Round Lake Park, IL 60073-3444 | 2020-04-27 |
| 1861038200 | Ease of Mind Pllc | Psychologist | 10526 West Cermak Road, Suite 308aa, Westchester, IL 60154 | 2019-11-20 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on DEBRA DIETRICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.