| Doctor Name: | MRS. MARIE DIANA GUELKER |
| NPI Number: | 1255731535 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.P.C. |
| License Number: | 2012007306 |
| Business Practice Address: | 3108 Edwards Pl Unit 304 Maryland Heights, MO - 630431865 |
| Business Phone Number: | 3147073985 |
| Business Fax Number: | 3147861397 |
| Mailing Address: | 3108 Edwards Pl, Unit 304 MARYLAND HEIGHTS |
| State: | MO |
| Postal Code: | 630431865 |
| Phone Number: | 3147073985 |
| Fax Number: | 3147861397 |
| NPI Enumeration Date: | 08/24/2014 |
| NPI Last Update Date: | 08/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2012007306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |