Provider Demographics
NPI:1346447372
Name:MCGUIRE, DIANNA L (LPC LADC)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:L
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LPC LADC
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:L
Other - Last Name:RANDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC LADC
Mailing Address - Street 1:1138 N FAULKNER PL
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-6614
Mailing Address - Country:US
Mailing Address - Phone:918-384-0002
Mailing Address - Fax:918-384-0004
Practice Address - Street 1:1138 N FAULKNER PL
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6614
Practice Address - Country:US
Practice Address - Phone:918-384-0002
Practice Address - Fax:918-384-0004
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK523101YA0400X
OK3552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health