Provider Demographics
NPI:1396180915
Name:DILBER, ANA (MA LPC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:DILBER
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 PROSPECT AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6024
Mailing Address - Country:US
Mailing Address - Phone:314-704-9631
Mailing Address - Fax:
Practice Address - Street 1:140 PROSPECT AVENUE
Practice Address - Street 2:SUITE D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6052
Practice Address - Country:US
Practice Address - Phone:314-704-9631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012040540101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor