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NPI Code Detail

MEDICARE: DALIA ANTUNEZ MSW, LCSWA

MEDICARE:   DALIA  ANTUNEZ  MSW, LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP014912NC

General Provider Information

NPI Number : 1194486670
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALIA ANTUNEZ MSW, LCSWA
Provider Business Mailing Address
First Line : 134 INFIELD CT
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-8026
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Provider Business Practice Location Address
First Line : 280 CHARLOIS BLVD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-1588
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2022
Last Update Date : 01/06/2022

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