Individual
WANDA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22605 COVERDALE RD, SEAFORD, DE 19973-7044
(302) 573-1247
Mailing address
22605 COVERDALE RD, SEAFORD, DE 19973-7044
(302) 573-1247
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000512
—
DE
Enumeration date
11/25/2020
Last updated
11/25/2020
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