Individual
GEETA KOTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1500 SHALLCROSS AVE STE 1A-2, WILMINGTON, DE 19806-3037
(302) 455-8990
Mailing address
1500 SHALLCROSS AVE STE 1A-2, WILMINGTON, DE 19806-3037
(302) 455-8990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0001642
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1R9389
MEDICARE
DE
Enumeration date
12/10/2019
Last updated
01/05/2022
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