Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 69427 | DE |
NPI | 1073948527 |
---|---|
Provider Name | Melinda R Landry |
First Address | Frankford, DE 19945 |
Second Address | Frankford, DE 19945-2616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2013 |
Last Update Date | 03/09/2013 |