Provider Demographics
NPI:1932159795
Name:VEACH, DIANE I (PSYD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:I
Last Name:VEACH
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 CHATHAM SQUARE OFFICE PARK
Mailing Address - Street 2:SUITE #101
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405
Mailing Address - Country:US
Mailing Address - Phone:540-373-9577
Mailing Address - Fax:540-373-6266
Practice Address - Street 1:406 CHATHAM SQUARE OFFICE PARK
Practice Address - Street 2:SUITE #101
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2585
Practice Address - Country:US
Practice Address - Phone:540-373-9577
Practice Address - Fax:540-373-6266
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040028761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical