Healthcare Provider Details
I. General information
NPI: 1972638872
Provider Name (Legal Business Name): ERIN DELIA MCLAUGHLIN MS ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 N DUPONT HWY RM 109
DOVER DE
19901-2202
US
IV. Provider business mailing address
533 BEECH TREE LN
HOCKESSIN DE
19707-1155
US
V. Phone/Fax
- Phone: 302-857-7554
- Fax: 302-857-7553
- Phone: 302-239-4193
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | J3-0000276 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: