Individual
LISA S DIERDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
301 SOVEREIGN CT STE 211, BALLWIN, MO 63011-4435
(636) 346-1132
Mailing address
301 SOVEREIGN CT STE 211, BALLWIN, MO 63011-4435
(636) 346-1132
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015019936
MO
Other
Enumeration date
03/10/2021
Last updated
08/03/2021
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