Organization
LIFE SPAN DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAMONTE G WILSON LCSW (OWNER/CLINICIAN)
(302) 399-5773
Entity
Organization
Contact information
Practice address
260 CHAPMAN RD, SUITE 200-1, NEWARK, DE 19702-5490
(302) 399-5773
(302) 832-9795
Mailing address
260 CHAPMAN RD, SUITE 200-1, NEWARK, DE 19702-5490
(302) 399-5773
(302) 832-9795
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0000548
DE
Other
Enumeration date
10/12/2016
Last updated
06/22/2017
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