Provider Demographics
NPI:1558406322
Name:GERHART, DIANA ROBIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:ROBIN
Last Name:GERHART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34969 CHARLES TOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-1800
Mailing Address - Country:US
Mailing Address - Phone:540-668-6697
Mailing Address - Fax:540-668-0463
Practice Address - Street 1:34969 CHARLES TOWN PIKE
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-1800
Practice Address - Country:US
Practice Address - Phone:703-727-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001682103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical