Individual
MRS. DIANE MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC
Contact information
Practice address
5414 SAVANNAH RD, SAINT JOSEPH, MO 64505-1146
(816) 364-4292
(816) 364-2648
Mailing address
5414 SAVANNAH RD, SAINT JOSEPH, MO 64505-1146
(816) 364-4292
(816) 364-2648
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001765
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001263101
COMMUNITY HEALTH PLAN
MO
01
—
22330031
BLUE CROSS BLUE SHIELD
MO
Enumeration date
12/14/2006
Last updated
07/08/2007
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