Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 68905 | DE |
NPI | 1083044127 |
---|---|
Provider Name | Kathleen Eaken |
First Address | Bear, DE 19701-1323 |
Second Address | Bear, DE 19701-1323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2013 |
Last Update Date | 26/11/2013 |