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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