Healthcare Provider Details

I. General information

NPI: 1356941728
Provider Name (Legal Business Name): JANEEN MCCOWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N RAMUNNO DR
MIDDLETOWN DE
19709-3003
US

IV. Provider business mailing address

410 N RAMUNNO DR
MIDDLETOWN DE
19709-3003
US

V. Phone/Fax

Practice location:
  • Phone: 302-293-8400
  • Fax:
Mailing address:
  • Phone: 302-293-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: