| NPI | 1134323322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA PUTNAM Manager 302-454-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B10000472) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2013-04-17 |