Healthcare Provider Details
I. General information
NPI: 1407087588
Provider Name (Legal Business Name): ANNETTE NABER PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 JACKSON RIVER ROAD
MONTEREY VA
24465-0490
US
IV. Provider business mailing address
120 JACKSON RIVER ROAD
MONTEREY VA
24465-0490
US
V. Phone/Fax
- Phone: 540-468-3300
- Fax: 540-465-3301
- Phone: 540-468-3300
- Fax: 540-465-3301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 0810003650 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: