Healthcare Provider Details

I. General information

NPI: 1265557474
Provider Name (Legal Business Name): NAN FUERTH SCHIOWITZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRUBB RD SUITE 240
WILMINGTON DE
19810-4799
US

IV. Provider business mailing address

725 S WARNOCK ST
PHILADELPHIA PA
19147-1927
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-1880
  • Fax: 302-475-2964
Mailing address:
  • Phone: 215-439-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0000263
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: