Individual
DIANE VICTORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMFT
Contact information
Practice address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 563-6500
Mailing address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 563-6500
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
03020
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201140500A
—
KS
Enumeration date
09/02/2016
Last updated
01/13/2021
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