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NPI Code Detail

MEDICARE: MRS. DIANE CLARE STAPLETON L.P.C.

MEDICARE:  MRS. DIANE CLARE STAPLETON  L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor0003394CO
2101YP2500XProfessional Counselor0003394CO

General Provider Information

NPI Number : 1790565406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE CLARE STAPLETON L.P.C.
Provider Business Mailing Address
First Line : 2602 DENVER BLVD
Second Line :
City : PUEBLO
State : CO
Zip : 81003-1447
Country : US
Telephone Number : 719-320-0710
Fax Number :
Provider Business Practice Location Address
First Line : 2602 DENVER BLVD
Second Line :
City : PUEBLO
State : CO
Zip : 81003-1447
Country : US
Telephone Number : 719-320-0710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2023
Last Update Date : 10/02/2023

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Directions to “ MRS. DIANE CLARE STAPLETON L.P.C.” Practice Location

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