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Organization
DIANE MENKE PENCE, LLC
Active
Organization
DIANE MENKE PENCE, LLC
Active
Other names
Diane Menke Pence, LMHC
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MENKE PENCE LMHC (OWNER)
(812) 876-6322
Entity
Organization
Contact information
Practice address
205 N COLLEGE AVE, STE 613, BLOOMINGTON, IN 47404-3950
(812) 333-3440
(812) 333-3444
Mailing address
1522 N LIMESTONE DR, ELLETTSVILLE, IN 47429-9363
(812) 876-6322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002125A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158893992
NPI INDIVUDAL
IN
Enumeration date
06/15/2010
Last updated
06/15/2010
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