Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | B1-0000299 | DE |
N | 103TH0100X | Health Service | PS015855 | PA |
NPI | 1093922171 |
---|---|
Provider Name | Valarie Molaison |
First Address | Wilmington, DE 19808-1342 |
Second Address | Wilmington, DE 19808-1342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |