| NPI | 1861757270 |
|---|---|
| Former Name | ANDREA DIERKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN 4919) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.009761) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2013-02-25 |