Provider Demographics
NPI:1780149377
Name:NEWBY, DIANNA M (CDCA)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:M
Last Name:NEWBY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:PA
Mailing Address - Zip Code:16161-0303
Mailing Address - Country:US
Mailing Address - Phone:330-953-0243
Mailing Address - Fax:
Practice Address - Street 1:9955 UNION RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:OH
Practice Address - Zip Code:44455-9763
Practice Address - Country:US
Practice Address - Phone:330-953-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH168942101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)