STACY R DIERKS

GRANITE CITY, IL
NPI1104185107
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2012-05-10
Last Update Date2012-05-10
Business Address
Ms. STACY R DIERKS BA, CADC
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL 62040-6805
Phone number: 618-877-4420
Mailing Address
Ms. STACY R DIERKS BA, CADC
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL 62040-6805
Phone number: 618-877-4420
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