Provider Demographics
NPI:1538413067
Name:NEWBY, DENISE LEAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LEAH
Last Name:NEWBY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 HOLIDAY CT
Mailing Address - Street 2:STE. 30
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-4365
Mailing Address - Country:US
Mailing Address - Phone:540-905-9135
Mailing Address - Fax:
Practice Address - Street 1:419 HOLIDAY CT
Practice Address - Street 2:STE. 30
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-4365
Practice Address - Country:US
Practice Address - Phone:540-905-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004663103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist