Doctor Name: | MR. DALE SCOTT PADDOCK |
NPI Number: | 1013163583 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED., LSW |
License Number: | S 0700342 |
Business Practice Address: | 104 Javit Ct Austintown, OH - 445152439 |
Business Phone Number: | 3307974050 |
Business Fax Number: | |
Mailing Address: | 5719 Southern Blvd, YOUNGSTOWN |
State: | OH |
Postal Code: | 445122922 |
Phone Number: | 3305192832 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2008 |
NPI Last Update Date: | 08/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | S 0700342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |