Individual
DR. PATRICIA DIEFENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND, CNS, CPT
Contact information
Practice address
6907 BRIMSTONE LN, FAIRFAX STATION, VA 22039-1819
(703) 609-8717
Mailing address
1900 MOUNT VERNON AVE STE 206, ALEXANDRIA, VA 22301-1302
(703) 609-8717
(703) 239-1565
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
175F00000X
Naturopath
000538
CT
175F00000X
Naturopath
0053
DC
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/24/2015
Last updated
03/03/2020
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