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General NPI Number Information
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NPI Number | 1023790250
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Entity Type | Individual
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Provider Name | DIANE MCCONNELL LPC
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 2335 GRANDVIEW AVE
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City | CINCINNATI
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State | OH
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Zip | 45206-2219
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Country | US
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Telephone | 937-477-6424
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Fax |
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Provider Business Mailing Address
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Address Line | 505 SHEPHERDS WAY
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City | MORROW
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State | OH
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Zip | 45152-7948
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Country | US
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Telephone | 937-477-6424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0007448
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License Number State | OH
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