Healthcare Provider Details

I. General information

NPI: 1780507418
Provider Name (Legal Business Name): ROOTS: STRONG SUPPORT. STRONGER FUTURES.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 PHEASANT RUN DR
WILMINGTON DE
19810-3322
US

IV. Provider business mailing address

18 PHEASANT RUN DR
WILMINGTON DE
19810-3322
US

V. Phone/Fax

Practice location:
  • Phone: 302-547-7079
  • Fax:
Mailing address:
  • Phone: 302-547-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA RAPPUCCI
Title or Position: OT
Credential: OT
Phone: 302-547-7079