Healthcare Provider Details

I. General information

NPI: 1255570602
Provider Name (Legal Business Name): CENTRAL DELAWARE SPEECH-LANGUAGE PATHOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S QUEENS ST
DOVER DE
19904-3568
US

IV. Provider business mailing address

725 S QUEEN ST
DOVER DE
19904-3568
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-3350
  • Fax: 928-752-3350
Mailing address:
  • Phone: 302-674-3350
  • Fax: 928-752-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number01-03-1130
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01-0001086
License Number StateDE

VIII. Authorized Official

Name: KATHLEEN ANDERSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 302-674-3350