Individual
MRS. SABRINA COLLEEN DIERKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
201 S RALEIGH RD, OCCUPATIONAL HEALTH DEPT., ENID, OK 73701-7800
(580) 616-4793
(580) 616-1071
Mailing address
201 S RALEIGH RD, OCCUPATIONAL HEALTH DEPT., ENID, OK 73701-7800
(580) 616-4793
(580) 616-1071
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
522
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04115786643
AHA BLS INSTUCTOR
OK
01
—
090402325
NATIONAL CERTIFICATION
—
01
—
522
STATE LICENSE NUMBER
OK
Enumeration date
08/13/2008
Last updated
06/26/2015
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