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1550 S Governors Ave Dover DE 19904-7020 | |
| (302) 678-4558 | |
| (302) 678-4577 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1550 S Governors Ave, Dover, Delaware |
| Authorized Official Name and Position | Joseph B Hicks (OWNER) |
| Authorized Official Contact | 3024365868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1550 S Governors Ave Dover DE 19904-7020 Ph: (302) 678-4558 | 1550 S Governors Ave Dover DE 19904-7020 Ph: (302) 678-4558 |
| NPI Number | 1568502888 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 09/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568502888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0000043 (Delaware) | Primary |
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