Individual
NANCY M DEVEREUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
501 WEST 14TH STREET, 6TH FLOOR, WILMINGTON, DE 19801
(302) 428-6756
(302) 428-6750
Mailing address
200 HYGEIA DRIVE, PHYSICIAN CONTRACTING - SUITE 2300, NEWARK, DE 19713
(302) 623-7010
(302) 623-0394
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071005310
IL
103G00000X
Clinical Neuropsychologist
Primary
B1-0001049
DE
103T00000X
Psychologist
B1-0001049
DE
103TC0700X
Clinical Psychologist
071005310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363236791
TAX ID
IL
Enumeration date
12/04/2006
Last updated
03/24/2016
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