Provider Demographics
NPI:1497267413
Name:RICE, CHRISTOPHER G
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:G
Last Name:RICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:G
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSY
Mailing Address - Street 1:1311 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2306
Mailing Address - Country:US
Mailing Address - Phone:302-793-5072
Mailing Address - Fax:
Practice Address - Street 1:1311 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2306
Practice Address - Country:US
Practice Address - Phone:302-793-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE89217103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling