Individual
GERALDINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6195 WHITE DEER RD, DELMAR, DE 19940-3143
(302) 846-3820
Mailing address
6195 WHITE DEER RD, DELMAR, DE 19940-3143
(302) 846-3820
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000590
—
DE
Enumeration date
11/20/2020
Last updated
11/20/2020
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