Healthcare Provider Details

I. General information

NPI: 1154211670
Provider Name (Legal Business Name): MARTHA LENONA DIGGINS PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 S MAIN ST
SAINT CHARLES MO
63303-4149
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 636-224-1000
  • Fax: 636-669-1010
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025026018
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: