Healthcare Provider Details

I. General information

NPI: 1750878161
Provider Name (Legal Business Name): HEATHER EMRICK CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAST ST
HARRINGTON DE
19952-1320
US

IV. Provider business mailing address

3821 LANCASTER PIKE
WILMINGTON DE
19805-1512
US

V. Phone/Fax

Practice location:
  • Phone: 302-786-7800
  • Fax:
Mailing address:
  • Phone: 302-442-6634
  • Fax: 302-984-3385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1563
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: