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General NPI Number Information
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NPI Number | 1114191350
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Entity Type | Organization
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Legal Business Name | THE AUTISM SHOPPE
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 506 HOPEWELL DR
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City | CLAYTON
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State | DE
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Zip | 19938-2228
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Country | US
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Telephone | 302-242-0942
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Fax | 302-223-6737
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Provider Business Mailing Address
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Address Line | 506 HOPEWELL DR
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City | CLAYTON
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State | DE
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Zip | 19938-2228
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Country | US
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Telephone | 302-242-0942
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Fax | 302-223-6737
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DAWN ROXANNE GADAINGAN SIMMONS
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Credential |
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Telephone | 302-242-0942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2006207052
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License Number State | DE
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