NPI 1124110911 · live from the CMS NPI Registry
Susan M. Jackson-Walker, PHD
Psychologist, Clinical Child & Adolescent in Wilmington, DE. National Provider Identifier 1124110911, active.
NPI record
| NPI | 1124110911 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical Child & Adolescent 103TC2200X |
| Practice location | A.I. Dupont Hospital For Children, 1600 Rockland Road, Wilmington, DE 19803 |
| Practice phone | 302-651-4000 |
| Mailing address | Nemours Childrens Clinic, P.O. Box 404112, Atlanta, GA 30384 |
| Enumerated | September 29, 2006 |
| Last updated | May 16, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical Child & Adolescent primary | 103TC2200X | B10000648 (DE) |
| Pediatrics, Developmental - Behavioral Pediatrics | 2080P0006X | B10000648 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.