Judith Green

Individual provider Active NPI School Psychologist · Odessa, DE

NPI 1043354772 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043354772
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
10780 (DE)
Practice address
118 South Sixth St
Odessa, DE 19730
Phone
(302) 376-4128
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10780DEMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appoquinimink School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 10780 DE Yes

Addresses

Primary practice location

118 South Sixth St
Odessa, DE 19730

Mailing address

118 South Sixth St
Odessa, DE 19730

Other providers in Odessa, DE

All providers in Odessa, DE · School Psychologist in Delaware

Sources for this page

Verify at the official NPI Registry.