Provider Demographics
NPI:1255127007
Name:DELOATCH, ORA EDWARDENA
Entity type:Individual
Prefix:
First Name:ORA
Middle Name:EDWARDENA
Last Name:DELOATCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 MATTHEW FLOCCO DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2350
Mailing Address - Country:US
Mailing Address - Phone:215-280-6209
Mailing Address - Fax:
Practice Address - Street 1:358 MATTHEW FLOCCO DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2350
Practice Address - Country:US
Practice Address - Phone:215-280-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health