Individual
DORIS DIMAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
103 LIBERTY PLZ, UNION, MO 63084-1163
(636) 357-3816
Mailing address
5266 HACKMANN RD, AUGUSTA, MO 63332-1733
(636) 357-3816
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2018014426
MO
Other
Enumeration date
05/26/2018
Last updated
05/26/2018
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