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General NPI Number Information
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NPI Number | 1487614301
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Entity Type | Individual
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Provider Name | ANNE C DIBALA MD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 71 S FLANNAGAN AVENUE
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City | LEBANON
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State | VA
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Zip | 24266
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Country | US
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Telephone | 276-883-8042
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Fax | 276-883-8044
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Provider Business Mailing Address
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Address Line | 71 S FLANNAGAN AVENUE
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City | LEBANON
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State | VA
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Zip | 24266
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Country | US
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Telephone | 276-883-8042
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Fax | 276-883-8044
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 13214
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101047498
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License Number State | VA
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