Organization
DINAH H NIEBURG, PHD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DINAH H NIEBURG PHD (MANAGER)
(434) 977-0033
Entity
Organization
Contact information
Practice address
1110 ROSE HILL DR, SUITE 201, CHARLOTTESVILLE, VA 22903-5159
(434) 977-0033
(434) 220-3335
Mailing address
1110 ROSE HILL DR, SUITE 201, CHARLOTTESVILLE, VA 22903-5159
(434) 977-0033
(434) 220-3335
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810002889
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081721M
OPTIMA FAMILY CARE
VA
01
—
1831126135
VALUE OPTIONS
VA
01
—
1831126135
VIRGINIA PREMIER
—
01
—
208466
ANTHEM BCBS
VA
Enumeration date
03/11/2007
Last updated
06/21/2018
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