Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 57436 | DE |
NPI | 1023394640 |
---|---|
Provider Name | Derick Whitcher |
First Address | Lewes, DE 19958-1735 |
Second Address | Lewes, DE 19958-1735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2011 |
Last Update Date | 27/10/2011 |