Virginia L Dikeman, MA
Individual provider Active NPI Psychologist · Clarks Summit, PA
NPI 1497964779 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497964779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PS6498L (PA)
- Practice address
- 1023 Woodland Way
Clarks Summit, PA 18411-2713 - Phone
- (570) 586-1467
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS6498L | PA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS6498L | PA | Yes |
Addresses
Primary practice location
1023 Woodland Way
Clarks Summit, PA 18411-2713
Mailing address
1023 Woodland Way
Clarks Summit, PA 18411-2713
Phone (570) 586-1467
Other providers in Clarks Summit, PA
- Michael F Desarno
- Christine Desousa
- Thomas Ernest Di Matteo
- Tracy Lee Di Mattia
- Michelle L Dickson
- Nicole Rene Dixon
- Kathleen Doherty
- Martin Andrew Donahue
- William Francis Dougherty
- Romas Dovydaitis
All providers in Clarks Summit, PA · Psychologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.