| NPI | 1508320169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY TIPPITT Office Manager 302-791-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |