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NPI Code Detail

MEDICARE: DYLAN DIEHL

MEDICARE: DYLAN DIEHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorCDCA.193996OH

General Provider Information

NPI Number : 1568317485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN DIEHL
Provider Business Mailing Address
First Line : 3509 DEEPWOOD DR
Second Line :
City : LAMBERTVILLE
State : MI
Zip : 48144-9686
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3231 CENTRAL PARK W STE 106
Second Line :
City : TOLEDO
State : OH
Zip : 43617-3009
Country : US
Telephone Number : 844-316-7599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ DYLAN DIEHL ” Practice Location

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