Individual
DIANE MENKE PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LPC
Contact information
Practice address
2536 S OLD HIGHWAY 94, SUITE 234, SAINT CHARLES, MO 63303-5612
(636) 896-5842
Mailing address
1337 PINE BLUFF DR, SAINT CHARLES, MO 63304-8785
(217) 549-9292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2016031492
MO
101YM0800X
Mental Health Counselor
39002125
IN
101YM0800X
Mental Health Counselor
LPC.0012588
CO
Other
Enumeration date
12/14/2009
Last updated
10/14/2016
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