Individual
DR. DIANE T GOTTLIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
478
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011764
TRICARE VALUE OPTIONS
VT
01
—
01260007
MAGELLEN MASS
MA
05
—
1003835
—
VT
01
—
108058
UNITED BEHAVIORAL HEALTH
VT
01
—
223960
COMPSYCH
VT
01
—
64071
CIGNA
VT
01
—
8064
BC AND BS
VT
01
—
T000511
CHAMPUS TRICARE
VT
Enumeration date
11/13/2006
Last updated
07/09/2007
Update your record
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