Individual
DEVIN DIERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
13109 SAND RD, FULTON, IL 61252-9853
(563) 321-7650
Mailing address
13109 SAND RD, FULTON, IL 61252-9853
(563) 321-7650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
086305
IA
1041C0700X
Clinical Social Worker
Primary
149.021003
IL
Other
Enumeration date
04/19/2017
Last updated
10/04/2021
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