Individual
DIU HA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W BROADWAY STE F, COLUMBIA, MO 65203-3842
(573) 214-0436
(573) 442-0606
Mailing address
201 W BROADWAY STE F, COLUMBIA, MO 65203-3842
(573) 214-0436
(573) 442-0606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
07/21/2022
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