Individual
DIMA SHABANEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
111 MEXICO CT, SAINT PETERS, MO 63376-5102
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024049084
MO
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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