Healthcare Provider Details

I. General information

NPI: 1598381055
Provider Name (Legal Business Name): DELANA ANN POORE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DELANA ANN MUNSTERMAN

II. Dates (important events)

Enumeration Date: 06/21/2020
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W 4TH ST
APPLETON CITY MO
64724-1402
US

IV. Provider business mailing address

106 W 4TH ST
APPLETON CITY MO
64724-1402
US

V. Phone/Fax

Practice location:
  • Phone: 660-207-8182
  • Fax:
Mailing address:
  • Phone: 660-207-8182
  • Fax: 660-476-5749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2020017544
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: