Jackie Dietz, is a
Speech-language Pathologist based in Gaylord, Minnesota. Jackie Dietz is licensed to practice in Minnesota (license number 8784) and her current practice location is
640 3rd St, Gaylord, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(507) 237-8730.
NPI number for Jackie Dietz is 1881938397 and her current mailing address is 640 3rd St, Gaylord, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1881938397.
Healthcare Provider's Profile
Full Name | Jackie Dietz |
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Gender | Female |
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Speciality | Speech-language Pathologist |
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Location | 640 3rd St, Gaylord, Minnesota |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1881938397
- Provider Enumeration Date: 11/21/2012
- Last Update Date: 11/21/2012
Medical Identifiers
Medical identifiers for Jackie Dietz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881938397 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
235Z00000X | Speech-language Pathologist | 8784 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie Dietz is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jackie Dietz, 640 3rd St, Gaylord, MN 55334-2297 Ph: (507) 237-8730 | Jackie Dietz, 640 3rd St, Gaylord, MN 55334-2297 Ph: (507) 237-8730 |
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