Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | B1-0000611 | DE |
N | 103T00000X | Psychologist | B1-0000611 | DE |
N | 103G00000X | Clinical Psychologist | B1-0000611 | DE |
N | 103TC0700X | Clinical Psychologist | B1-0000611 | DE |
NPI | 1013056860 |
---|---|
Provider Name | Dr. Lisa Deleonardo |
First Address | Wilmington, DE 19808-1250 |
Second Address | Wilmington, DE 19808-1250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |