Healthcare Provider Details

I. General information

NPI: 1902037997
Provider Name (Legal Business Name): CONNECTIONS CSP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 10TH ST
WILMINGTON DE
19801-1422
US

IV. Provider business mailing address

500 W 10TH ST
WILMINGTON DE
19801-1422
US

V. Phone/Fax

Practice location:
  • Phone: 302-984-3380
  • Fax: 302-984-3329
Mailing address:
  • Phone: 302-984-3380
  • Fax: 302-984-3329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS DEVANEY
Title or Position: VP PROGRAM OPERATIONS
Credential:
Phone: 302-984-3380