Roderick Bookard
Psychologist, Intellectual & Developmental Disabilities in Camden-Wyoming, DE. Individual provider (NPI-1).
NPI number1215683404
StatusActive
Last updated in NPPESJun 28, 2024
Details
- NPI
- 1215683404
- Entity type
- Individual (NPI-1)
- Name
- Roderick Bookard
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 25, 2022
- Certification date
- Jun 20, 2024
- Last updated
- Jun 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TM1800X | Psychologist, Intellectual & Developmental Disabilities | – | – | Yes |
Practice location
718 Ashland AveCamden-Wyoming, DE 19934-5429
Phone 302-573-1231
Mailing address
236 E Braeburn DrSmyrna, DE 19977-3930
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