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Provider Information for 1629050711


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Ms. MARYLOU FOSTER BIASOTTO LCSW


Sex: Female

NPI: 1629050711
Last Updated: 2017-01-09
Certification Date:

Details

NameValue
NPI1629050711
Enumeration Date2005-11-15
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1521 CONCORD PIKE
SUITE 103
WILMINGTON, DE 19803-3642
United States

Phone: 302-428-0205 | Fax:302-428-1123
 
Primary Practice Address 25 OMEGA DR BLDG J
NEWARK, DE 19713-6020
United States

Phone: 302-428-0205 | Fax:302-428-1123
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalDEQ1-0000539