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NPI Code Detail

MEDICARE: ROMONA PATILLO SCHOOL PSYCHOLOGIST

MEDICARE: ROMONA PATILLO SCHOOL PSYCHOLOGIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool PsychologistDOE CERT. 24714DE

General Provider Information

NPI Number : 1578713632
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROMONA PATILLO SCHOOL PSYCHOLOGIST
Provider Business Mailing Address
First Line : 278 SORGHUM MILL RD
Second Line :
City : CAMDEN
State : DE
Zip : 19934-1935
Country : US
Telephone Number : 302-697-3103
Fax Number :
Provider Business Practice Location Address
First Line : 278 SORGHUM MILL RD
Second Line :
City : CAMDEN
State : DE
Zip : 19934-1935
Country : US
Telephone Number : 302-697-3103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2008
Last Update Date : 09/25/2008

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Directions to “ ROMONA PATILLO SCHOOL PSYCHOLOGIST” Practice Location

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