Provider Demographics
NPI:1609401835
Name:DINWIDDIE, ELIZABETH BRANCH (MA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRANCH
Last Name:DINWIDDIE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:DINWIDDIE
Other - Last Name:LEINAAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2833 MILTON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-7603
Mailing Address - Country:US
Mailing Address - Phone:423-491-0060
Mailing Address - Fax:
Practice Address - Street 1:887 RIO EAST CT # B
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8004
Practice Address - Country:US
Practice Address - Phone:434-220-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-0605889101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool