Provider Demographics
NPI:1457069304
Name:DIETEL, ROBIN LYNN (CLD, CPD, IBCLC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:DIETEL
Suffix:
Gender:F
Credentials:CLD, CPD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110565 COUNTY ROAD P
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54484-4461
Mailing Address - Country:US
Mailing Address - Phone:715-316-1399
Mailing Address - Fax:
Practice Address - Street 1:110565 COUNTY ROAD P
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:WI
Practice Address - Zip Code:54484-4461
Practice Address - Country:US
Practice Address - Phone:715-316-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula