Provider Demographics
NPI:1104493147
Name:FABRY, DIANAH (BA)
Entity type:Individual
Prefix:
First Name:DIANAH
Middle Name:
Last Name:FABRY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 8TH AVE RM 136
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4506
Mailing Address - Country:US
Mailing Address - Phone:724-371-8055
Mailing Address - Fax:
Practice Address - Street 1:1020 8TH AVE RM 136
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4506
Practice Address - Country:US
Practice Address - Phone:724-371-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health