Individual
PATRICIA DIERKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 1ST ST, GRAND PASS, MO 65339-1200
(660) 202-7515
Mailing address
2003 1ST ST, GRAND PASS, MO 65339-1200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01830
MO
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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