Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | Q1-0001563 | DE |
NPI | 1003472523 |
---|---|
Provider Name | Caitlin Fitzpatrick |
First Address | Middletown, DE 19709-3063 |
Second Address | Newark, DE 19711-7231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2019 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164993143 | SANDRA COOPER (01) | DE |