Provider Demographics
NPI:1932404860
Name:PSYCHOLOGICAL AND DIVORCE MEDIATION SERVICES INC
Entity type:Organization
Organization Name:PSYCHOLOGICAL AND DIVORCE MEDIATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:FRANGIA
Authorized Official - Last Name:RAYIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-547-8479
Mailing Address - Street 1:1601 MILLTOWN RD STE 121601
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4027
Mailing Address - Country:US
Mailing Address - Phone:302-547-8479
Mailing Address - Fax:
Practice Address - Street 1:1601 MILLTOWN RD STE 12
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4084
Practice Address - Country:US
Practice Address - Phone:302-547-8479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty