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General NPI Number Information
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NPI Number | 1548048382
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Entity Type | Individual
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Provider Name | DOUGLAS PALMER CRC, CDMS
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Gender | Male
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 440 E SWEDESFORD RD STE 2045
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City | WAYNE
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State | PA
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Zip | 19087-1842
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Country | US
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Telephone | 207-303-4598
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Fax | 888-741-9222
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Provider Business Mailing Address
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Address Line | 440 E SWEDESFORD RD STE 2045
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City | WAYNE
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State | PA
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Zip | 19087-1842
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Country | US
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Telephone | 207-303-4598
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Fax | 888-741-9222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 15763
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License Number State | IL
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