Provider Demographics
NPI:1699417915
Name:DIERMEIER, DARLA (CEP)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:DIERMEIER
Suffix:
Gender:F
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E9465 COUNTY ROAD HH
Mailing Address - Street 2:
Mailing Address - City:ELK MOUND
Mailing Address - State:WI
Mailing Address - Zip Code:54739-9428
Mailing Address - Country:US
Mailing Address - Phone:715-838-3979
Mailing Address - Fax:715-838-5632
Practice Address - Street 1:1221 WHIPPLE ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-5200
Practice Address - Country:US
Practice Address - Phone:715-838-3979
Practice Address - Fax:715-838-5632
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI867069224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist