Provider Demographics
NPI:1487243788
Name:DIETEL, KATELIN (LGSW)
Entity type:Individual
Prefix:
First Name:KATELIN
Middle Name:
Last Name:DIETEL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:LESTER PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55354-0341
Mailing Address - Country:US
Mailing Address - Phone:612-205-9793
Mailing Address - Fax:
Practice Address - Street 1:114 MAIN ST N STE 201B
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1819
Practice Address - Country:US
Practice Address - Phone:651-346-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health