Individual
DR. JOHN WILLIAM DETTWYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
B10000210
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000621543
—
DE
05
—
1000025979
—
DE
Enumeration date
11/14/2006
Last updated
07/08/2007
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