# DIANE C. DIERKS, LMFT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700158912
- **Authorized official:** MRS. DIANE CHAMBERS DIERKS MFT (MEMBER)
- **Authorized official phone:** (404) 218-1739

## Contact information

- **Practice address:** 413 CONSTITUTION BLVD., SUITE D, LAWRENCEVILLE, GA 30046-4736
- **Practice address phone:** (404) 218-1739
- **Practice address fax:** (404) 592-1257
- **Mailing address:** 413 CONSTITUTION BLVD., SUITE D, LAWRENCEVILLE, GA 30046-1016
- **Mailing address phone:** (404) 218-1739
- **Mailing address fax:** (404) 592-1257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFT001084 | GA | Yes |

## Other

- **Enumeration date:** 02/02/2012
- **Last updated:** 04/04/2014