Healthcare Provider Details

I. General information

NPI: 1619781853
Provider Name (Legal Business Name): SILOE GARCIA ELIZALDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 CHAPMAN RD STE 104A
NEWARK DE
19702-5410
US

IV. Provider business mailing address

125 E MAIN ST
MIDDLETOWN DE
19709-1446
US

V. Phone/Fax

Practice location:
  • Phone: 302-273-3194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: