| NPI | 1063962512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI D HICKMAN Owner 302-690-4133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0001046) |
| Enumeration Date | 2016-10-08 |
| Last Update Date | 2016-10-08 |