Provider Demographics
NPI:1417841289
Name:HISPANIC AMERICAN ASSOCIATION OF DELAWARE, INC
Entity type:Organization
Organization Name:HISPANIC AMERICAN ASSOCIATION OF DELAWARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLO-MARZOL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPCMH
Authorized Official - Phone:302-668-6118
Mailing Address - Street 1:1801 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 E NEWPORT PIKE STE E
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-2346
Practice Address - Country:US
Practice Address - Phone:302-483-7914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health