Provider Demographics
NPI: | 1962047746 |
---|---|
Name: | CENTER FOR GRIEF THERAPY AND EDUCATION, P.A. |
Entity type: | Organization |
Organization Name: | CENTER FOR GRIEF THERAPY AND EDUCATION, P.A. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHRISTINA |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | ZAMPITELLA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSY D |
Authorized Official - Phone: | 302-635-0505 |
Mailing Address - Street 1: | 5500 SKYLINE DRIVE |
Mailing Address - Street 2: | SUITE 4 |
Mailing Address - City: | WILMINGTON |
Mailing Address - State: | DE |
Mailing Address - Zip Code: | 19808 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 302-635-0505 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5500 SKYLINE DRIVE |
Practice Address - Street 2: | SUITE 4 |
Practice Address - City: | WILMINGTON |
Practice Address - State: | DE |
Practice Address - Zip Code: | 19808 |
Practice Address - Country: | US |
Practice Address - Phone: | 302-635-0505 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-11-15 |
Last Update Date: | 2023-10-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Single Specialty |