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Individual

ELLA PAULINE DIERKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
201 OLD MAIN, UNIVERSITY PARK, PA 16802-1503
(425) 686-0099
Mailing address
190 STAMFORD HTS, STATE COLLEGE, PA 16803-5631
(425) 686-0099

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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