| NPI | 1174559918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL WIDDER Owner 302-736-1820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000180) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000004) |
| 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000249) | |
| 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000503) | |
| 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000831) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2013-01-17 |