Provider Demographics
NPI:1962148106
Name:WALLETT, GERI ELIZABETH (MSS)
Entity type:Individual
Prefix:MISS
First Name:GERI
Middle Name:ELIZABETH
Last Name:WALLETT
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16621 SAM LUCAS RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-2828
Mailing Address - Country:US
Mailing Address - Phone:302-604-3754
Mailing Address - Fax:
Practice Address - Street 1:505 MAIN ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:DE
Practice Address - Zip Code:19730-2013
Practice Address - Country:US
Practice Address - Phone:302-279-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker