Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 96063 | DE |
NPI | 1063833143 |
---|---|
Provider Name | Dr. Eric Sudler JR. |
First Address | Middletown, DE 19709-8741 |
Second Address | Milford, DE 19963-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2013 |
Last Update Date | 03/09/2019 |