Individual
MRS. DIANA MARIE HAROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2751 THOMAS DR, CAPE GIRARDEAU, MO 63701-2131
(573) 334-2889
(573) 651-9152
Mailing address
2751 THOMAS DR, CAPE GIRARDEAU, MO 63701-2131
(573) 334-2889
(573) 651-9152
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2001021755
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS 181123
LCSW
MO
Enumeration date
05/04/2007
Last updated
07/08/2007
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