Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 86542 | DE |
NPI | 1003365271 |
---|---|
Provider Name | Celia Teira Serrano |
First Address | Wilmington, DE 19806-3071 |
Second Address | Wilmington, DE 19805-2148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2016 |
Last Update Date | 28/09/2016 |