Healthcare Provider Details

I. General information

NPI: 1598631509
Provider Name (Legal Business Name): VICTORIA DIMURO PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13303 TESSON FERRY RD STE 50
SAINT LOUIS MO
63128-4062
US

IV. Provider business mailing address

13303 TESSON FERRY RD STE 50
SAINT LOUIS MO
63128-4062
US

V. Phone/Fax

Practice location:
  • Phone: 636-379-1779
  • Fax: 636-634-3496
Mailing address:
  • Phone: 636-379-1779
  • Fax: 636-634-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025044073
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: