Individual
LUCAS DIECKHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 WALNUT ST, WASHINGTON, MO 63090-2626
(314) 960-6720
Mailing address
305 WALNUT ST, WASHINGTON, MO 63090-2626
(314) 960-6720
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014022286
MO
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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