Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | DE |
NPI | 1013051994 |
---|---|
Provider Name | Robert Demerest |
First Address | New Castle, DE 19720-4214 |
Second Address | New Castle, DE 19720-4214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 26/07/2007 |