Healthcare Provider Details

I. General information

NPI: 1578452280
Provider Name (Legal Business Name): GRACE PIKUS CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 CHURCHMANS RD STE 100A
NEWARK DE
19702-1943
US

IV. Provider business mailing address

630 CHURCHMANS RD STE 100A
NEWARK DE
19702-1943
US

V. Phone/Fax

Practice location:
  • Phone: 302-544-5055
  • Fax:
Mailing address:
  • Phone: 302-544-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO4-0010918
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: