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General NPI Number Information
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NPI Number | 1346849965
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Entity Type | Organization
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Legal Business Name | THE HEALING GARDEN
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 2126 W NEWPORT PIKE
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City | NEWPORT
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State | DE
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Zip | 19804-3742
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Country | US
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Telephone | 267-304-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 INVERNESS CIR
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City | NEW CASTLE
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State | DE
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Zip | 19720-3819
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Country | US
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Telephone | 267-304-4200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA DAVID
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Credential | MS, LPCMH
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Telephone | 267-304-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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