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2015 Peachtree Run Rd Dover DE 19901 | |
| (302) 480-9340 | |
| (302) 480-9341 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 2015 Peachtree Run Rd, Dover, Delaware |
| Authorized Official Name and Position | Erin Oliver (TREASURER & CONTROLLER) |
| Authorized Official Contact | 4107781099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
104 Spring Ave Unit 299 Chestertown MD 21620-8512 Ph: (410) 778-1099 | 2015 Peachtree Run Rd Dover DE 19901 Ph: (302) 480-9340 |
| NPI Number | 1689699274 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689699274 | NPI | - | NPPES |
| 0000520561 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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