Organization
DIANE C. DIERKS, LMFT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE CHAMBERS DIERKS MFT (MEMBER)
(404) 218-1739
Entity
Organization
Contact information
Practice address
413 CONSTITUTION BLVD., SUITE D, LAWRENCEVILLE, GA 30046-4736
(404) 218-1739
(404) 592-1257
Mailing address
413 CONSTITUTION BLVD., SUITE D, LAWRENCEVILLE, GA 30046-1016
(404) 218-1739
(404) 592-1257
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001084
GA
Other
Enumeration date
02/02/2012
Last updated
04/04/2014
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