Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | B1-0001095 | DE |
NPI | 1073035754 |
---|---|
Provider Name | Dr. William Franklin Fishbein |
First Address | Lewes, DE 19958-2520 |
Second Address | Lewes, DE 19958-4393 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2017 |
Last Update Date | 13/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
81-0001095 | PSYCHOLOGIST PROFESSIONAL LICENSE (01) | DE |