Individual
MRS. DIANE MARIE KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8510 WORNALL RD, LIFE CENTER, KANSAS CITY, MO 64114-2918
(816) 361-2475
Mailing address
1604 COOPER DR, RAYMORE, MO 64083-8114
(816) 331-1563
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2002032331
MO
101YS0200X
School Counselor
2002032331
MO
Other
Enumeration date
02/13/2007
Last updated
01/24/2013
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