MS. Stacy R Dierks, BA, CADC
NPI #1104185107 in Granite City, Illinois
Provider Information
- NPI Number
- 1104185107
- Entity Type
- Individual
- Name
- MS. Stacy R Dierks, BA, CADC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- BA, CADC
- Enumeration Date
- May 10, 2012
- Last Updated
- May 10, 2012
Practice Location
- Address
- 50 NORTHGATE INDUSTRIAL DR
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-6805
- Phone
- (618) 877-4420
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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