Doctor Name: | KAREN SUSAN DIERKENS |
NPI Number: | 1043646607 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.C.C. |
License Number: | E0019326 |
Business Practice Address: | 4539 County Road 5 2 Delta, OH - 435159658 |
Business Phone Number: | 4194601860 |
Business Fax Number: | |
Mailing Address: | 4539 County Road 5 2, DELTA |
State: | OH |
Postal Code: | 435159658 |
Phone Number: | 4194601860 |
Fax Number: | |
NPI Enumeration Date: | 09/15/2013 |
NPI Last Update Date: | 09/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E0019326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |