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: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 S RED HAVEN LN
DOVER DE
19901-6483
US

IV. Provider business mailing address

541 S RED HAVEN LN
DOVER DE
19901-6483
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 Code103K00000X
TaxonomyBehavior Analyst
License Number01-03-1130
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01-0001086
License Number StateDE

VIII. Authorized Official

Name: KATHLEEN ANDERSON
Title or Position: PRACTICE ADMINISTRATOR
Credential: M.S. CCC-SLP
Phone: 302-674-3350