Healthcare Provider Details

I. General information

NPI: 1821388703
Provider Name (Legal Business Name): FELICIA A. CONNOR PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FELICIA BALDWIN

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND ROAD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

P.O. BOX 191
ROCKLAND DE
19723-0191
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4200
  • Fax: 302-651-5951
Mailing address:
  • Phone: 302-651-4000
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberB2-0000332
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: