Provider Demographics
NPI:1013343904
Name:APPAL, DIANE RENE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:RENE
Last Name:APPAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SPENCER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2576
Mailing Address - Country:US
Mailing Address - Phone:636-939-2550
Mailing Address - Fax:
Practice Address - Street 1:255 SPENCER RD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2576
Practice Address - Country:US
Practice Address - Phone:636-939-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011024839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2011024839OtherLICENSE