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4001 Kennett Pike Suite 244 Greenville DE 19807-2315 | |
(302) 777-1110 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 4001 Kennett Pike, Greenville, Delaware |
Authorized Official Name and Position | Carol Elaine Bouzoukis (SOLE PROPROETOR) |
Authorized Official Contact | 3027771110 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4001 Kennett Pike Suite 244 Greenville DE 19807-2315 Ph: (302) 777-1110 | 4001 Kennett Pike Suite 244 Greenville DE 19807-2315 Ph: (302) 777-1110 |
NPI Number | 1225564966 |
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Provider Enumeration Date | 05/01/2017 |
Last Update Date | 05/01/2017 |
Identifier | Type | State | Issuer |
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1225564966 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |