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Individual

JUANITA BRISCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
28291 FISHER RD, MILTON, DE 19968-3273
(302) 573-1247
Mailing address
28291 FISHER RD, MILTON, DE 19968-3273
(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
250568415
DE
Enumeration date
11/18/2020
Last updated
11/18/2020
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