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General NPI Number Information
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NPI Number | 1962888412
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Entity Type | Organization
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Legal Business Name | IESO DIGITAL HEALTH
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Dates
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Enumeration Date | 08/07/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 2711 CENTERVILLE RD SUITE 400
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City | WILMINGTON
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State | DE
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Zip | 19808-1660
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Country | US
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Telephone | 303-386-7142
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 CENTERVILLE RD SUITE 400
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City | WILMINGTON
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State | DE
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Zip | 19808-1660
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Country | US
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Telephone | 303-386-7142
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS/FINANCIAL OFFICER
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Name | MR. JULIAN COE
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Credential |
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Telephone | 303-386-7142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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