| NPI | 1235725623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN COREY Provider 302-644-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2025-01-27 |