Individual provider · Type 1 NPI

Stacy R. Dierks, BA, CADC

Addiction (Substance Use Disorder) Counselor · Granite City, IL

NPI number 1104185107 Active

Practice location

50 Northgate Industrial Dr
Granite City, IL 62040-6805

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104185107

Stacy R. Dierks, BA, CADC's National Provider Identifier is 1104185107, issued on May 10, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Granite City, IL. The record was last updated on May 10, 2012.