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General NPI Number Information
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NPI Number | 1538977574
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Entity Type | Individual
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Provider Name | DIANA DEPASQUALE LPC
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Gender | Female
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 440 E POE RD STE 202
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City | BOWLING GREEN
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State | OH
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Zip | 43402-4935
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Country | US
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Telephone | 193-702-8254
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Fax |
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Provider Business Mailing Address
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Address Line | 227 W MERRY AVE
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City | BOWLING GREEN
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State | OH
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Zip | 43402-1749
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Country | US
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Telephone | 419-370-2825
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2406678
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License Number State | OH
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