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1336172386
RUSSELL P WIDDER
DOVER, DE
NPI
1336172386
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: DE Q1-0000180)
Enumeration Date
2006-07-09
Last Update Date
2007-07-09
Business Address
RUSSELL P WIDDER LCSW
148 S BRADFORD ST
DOVER, DE 19904-7318
Phone number: 302-736-1820
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Mailing Address
RUSSELL P WIDDER LCSW
160 EGRET LN
WYOMING, DE 19934-4002
Phone number: 302-736-1820
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