Most Relevant Information
Provider Data
| NPI Number: | 1003358706 |
| Provider Name: | GRETCHEN DITTRICH |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 0005 |
Most Important Dates
| Enumeration Date: | 11/11/2016 |
| Last Updated: | 11/11/2016 |
Provider Practice Location
55 LAKE AVE N
WORCESTER
MA
016550002
Practice Location Phone/Fax
| Phone: | 7744422263 |
| Fax: | 7744422270 |
Provider Mailing Location
PO BOX 415348
BOSTON
MA
022415348
Provider Mailing Phone/Fax
| Phone: | 8002258885 |
| Fax: | 5083341977 |