Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1043868201 |
---|---|
Provider Name | Olivia Aquino |
First Address | New Castle, DE 19720-6057 |
Second Address | New Castle, DE 19720-6057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2019 |
Last Update Date | 30/08/2019 |