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Individual

DR. GLORY FOX DIERKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5691 COLUMBIA PIKE, SUITE 200, FALLS CHURCH, VA 22041
(703) 998-5606
(703) 998-5608
Mailing address
5691 COLUMBIA PIKE, SUITE 200, FALLS CHURCH, VA 22041
(703) 998-5606
(703) 998-5608

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
07010001557
VA
103TC0700X
Clinical Psychologist
Primary
0810002996
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0972793
AETNA
01
141701
ANTHEM BCBS
01
149749000
DEPARTMENT OF LABOR
01
2122848
MAMSI
01
2129080
FIRST HEALTH
01
28110004
ARLINGTON EAP PROVIDERS
01
2811004
CAREFIRST
VA
01
2811004
CAREFIRST
01
4481805
AETNA
01
461335000
MAGELLAN
01
541521659
AMERICAN BEHAVIORAL HLTH
05
7713690
VA
Enumeration date
11/20/2006
Last updated
02/26/2019
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