| State Of Delaware | |
|
417 Federal St Dover DE 19901-3635 | |
| (302) 744-4548 | |
| (302) 739-1613 |
| Full Name | State Of Delaware |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 417 Federal St, Dover, Delaware |
| Authorized Official Name and Position | Karyl Rattay (DIRECTOR) |
| Authorized Official Contact | 3027444700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Delaware 417 Federal St Dover DE 19901-3635 Ph: (302) 744-4548 | State Of Delaware 417 Federal St Dover DE 19901-3635 Ph: (302) 744-4548 |
| NPI Number | 1306918180 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 12/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306918180 | NPI | - | NPPES |
| 0000300957 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
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