Organization
PRISCILLA PUTNAM, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA PUTNAM PH.D. (MANAGER)
(302) 454-8010
Entity
Organization
Contact information
Practice address
168 S. MAIN ST., SUITE 208, NEWARK, DE 19711-7933
(302) 454-8010
(302) 454-8026
Mailing address
168 S. MAIN ST., SUITE 208, NEWARK, DE 19711-7933
(302) 454-8010
(302) 454-8026
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
B10000472
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF6995
PALMETTO GBA-RAILROAD MED
DE
Enumeration date
06/12/2007
Last updated
04/17/2013
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