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General NPI Number Information
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NPI Number | 1083164339
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 21 SAULSBURY ROAD
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City | DOVER
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State | DE
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Zip | 19904-2760
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Country | US
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Telephone | 302-922-1208
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Fax | 302-672-7158
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Provider Business Mailing Address
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Address Line | 21 SAULSBURY RD
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City | DOVER
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State | DE
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Zip | 19904-3444
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Country | US
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Telephone | 302-922-1208
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Fax | 302-672-7158
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MARCIA LYNN CLENDANIEL
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Credential |
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Telephone | 410-810-2465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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