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Individual

MRS. DIANE WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
413 HISTORIC 66 W, WAYNESVILLE, MO 65583-2114
(417) 260-5228
(866) 206-7178
Mailing address
16946 TIFFANY DR, HOUSTON, MO 65483-2521
(417) 260-5228
(866) 206-7178

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2005038586
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
497523209
MO
Enumeration date
01/30/2007
Last updated
07/18/2012
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