Provider Demographics
NPI:1518412535
Name:DIBELLA, LINDA MARIE (PHD, CHHC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARIE
Last Name:DIBELLA
Suffix:
Gender:F
Credentials:PHD, CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 BULL CREEK RD
Mailing Address - Street 2:2322
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5903
Mailing Address - Country:US
Mailing Address - Phone:203-641-5628
Mailing Address - Fax:
Practice Address - Street 1:4330 BULL CREEK RD
Practice Address - Street 2:2322
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-5903
Practice Address - Country:US
Practice Address - Phone:203-641-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education