Provider Demographics
NPI:1316173305
Name:MITCHELL-SCOTT, DIANE ELAINE (PLPC)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ELAINE
Last Name:MITCHELL-SCOTT
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 GARDENVIEW OFFICE PKWY
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5917
Mailing Address - Country:US
Mailing Address - Phone:636-724-5956
Mailing Address - Fax:
Practice Address - Street 1:939 GARDENVIEW OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5917
Practice Address - Country:US
Practice Address - Phone:636-724-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008032129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional