Healthcare Provider Details

I. General information

NPI: 1801559067
Provider Name (Legal Business Name): SIOBHAN JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S CHAPEL ST STE 102
NEWARK DE
19713-3468
US

IV. Provider business mailing address

910 S CHAPEL ST STE 102
NEWARK DE
19713-3468
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax: 302-224-1402
Mailing address:
  • Phone: 302-224-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0011836
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: