Doctor Name: | PHYLLIS I DALE |
NPI Number: | 1023239522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | SW2842 |
Business Practice Address: | 15424 Rosaire Ln Delray Beach, FL - 334844625 |
Business Phone Number: | 5613810483 |
Business Fax Number: | |
Mailing Address: | 15424 Rosaire Ln, DELRAY BEACH |
State: | FL |
Postal Code: | 334844625 |
Phone Number: | 5613810483 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW2842 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |