Individual
CAROLYN DIERCKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3176 ABBOTT RD UNIT 500, ORCHARD PARK, NY 14127-1069
(716) 822-2117
Mailing address
3176 ABBOTT RD UNIT 500, ORCHARD PARK, NY 14127-1069
(716) 822-2117
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/20/2022
Last updated
03/20/2022
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