Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6665 | OH |
Y | 103TC0700X | Clinical Psychologist | 6665 | OH |
NPI | 1003137068 |
---|---|
Provider Name | Danielle R Delong |
First Address | Toledo, OH 43606-3856 |
Second Address | Toledo, OH 43606-3856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 14/06/2010 |