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NPI Code Detail

MEDICARE: RAQUEL ILANIT HUERTA

MEDICARE:   RAQUEL ILANIT HUERTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1881199693
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAQUEL ILANIT HUERTA
Provider Business Mailing Address
First Line : 2100 HAVEN RD
Second Line : APT C
City : WILMINGTON
State : DE
Zip : 19809
Country : US
Telephone Number : 313-482-8683
Fax Number :
Provider Business Practice Location Address
First Line : 2100 HAVEN RD
Second Line : APT C
City : WILMINGTON
State : DE
Zip : 19809
Country : US
Telephone Number : 313-482-8683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 03/26/2018

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Directions to “ RAQUEL ILANIT HUERTA ” Practice Location

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