Provider Demographics
NPI:1477707354
Name:DIER, JENNIFER G (PLPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:G
Last Name:DIER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:G
Other - Last Name:DIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:307 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:MO
Mailing Address - Zip Code:65360-1449
Mailing Address - Country:US
Mailing Address - Phone:660-647-2182
Mailing Address - Fax:660-647-2217
Practice Address - Street 1:307 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:MO
Practice Address - Zip Code:65360-1449
Practice Address - Country:US
Practice Address - Phone:660-647-2182
Practice Address - Fax:660-647-2217
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008032351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health