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General NPI Number Information
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NPI Number | 1851646475
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Entity Type | Individual
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Provider Name | DONALD RODERICK MARKS PSYD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 1601 KIRKWOOD HIGHWAY
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City | WILMINGTON
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State | DE
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Zip | 19805
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Country | US
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Telephone | 215-534-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 STACKHOUSE DR
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City | YARDLEY
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State | PA
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Zip | 19067-1839
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Country | US
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Telephone | 215-534-0398
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Fax |
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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 | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PS017170
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License Number State | PA
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