Doctor Name: | MR. DIANE ZOELLER |
NPI Number: | 1346492881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | 2008031161 |
Business Practice Address: | 18614 Whiskey Creek Rd Wildwood, MO - 630692530 |
Business Phone Number: | 3145043828 |
Business Fax Number: | |
Mailing Address: | 337 Hunters Heights Dr, EUREKA |
State: | MO |
Postal Code: | 630251083 |
Phone Number: | 6365873400 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2008 |
NPI Last Update Date: | 10/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2008031161 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |