Individual
MR. MICHAEL DIBENEDETTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 CROWN PT, COLUMBIA, MO 65203-2202
(573) 875-1576
(573) 449-3171
Mailing address
375 CROWN POINT, COLUMBIA, MO 65203-2202
(573) 875-1576
(573) 449-3171
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000222
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493876015
—
MO
Enumeration date
12/15/2005
Last updated
01/31/2012
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