Provider Demographics
NPI:1487977484
Name:ROE, DENEEN L (MS, CAADC)
Entity type:Individual
Prefix:MRS
First Name:DENEEN
Middle Name:L
Last Name:ROE
Suffix:
Gender:F
Credentials:MS, CAADC
Other - Prefix:MISS
Other - First Name:DENEEN
Other - Middle Name:L
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CAADC
Mailing Address - Street 1:34 EMERSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-397-4164
Mailing Address - Fax:
Practice Address - Street 1:19500 PINE ROAD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:DE
Practice Address - Zip Code:19960
Practice Address - Country:US
Practice Address - Phone:302-397-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
DE1118101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty