Healthcare Provider Details

I. General information

NPI: 1497267413
Provider Name (Legal Business Name): CHRISTOPHER G RICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHRISTOPHER G RICE PSY

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 BRANDYWINE BLVD
WILMINGTON DE
19809-2306
US

IV. Provider business mailing address

1311 BRANDYWINE BLVD
WILMINGTON DE
19809-2306
US

V. Phone/Fax

Practice location:
  • Phone: 302-793-5072
  • Fax:
Mailing address:
  • Phone: 302-793-5072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number89217
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: