Provider Demographics
NPI:1033234794
Name:DIEHL, MARANDI ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARANDI
Middle Name:ANN
Last Name:DIEHL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARANDI
Other - Middle Name:ANN
Other - Last Name:BELLAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10600 E 26TH TER S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-3306
Mailing Address - Country:US
Mailing Address - Phone:816-392-8101
Mailing Address - Fax:
Practice Address - Street 1:10600 E 26TH TER S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3306
Practice Address - Country:US
Practice Address - Phone:816-392-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20004037102101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional