Healthcare Provider Details

I. General information

NPI: 1245043934
Provider Name (Legal Business Name): KARLY DEUTSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 CHURCH RD
NEWARK DE
19702-5101
US

IV. Provider business mailing address

506 N BARRETT LN
NEWARK DE
19702-2995
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO4-0010817
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: