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NPI Code Detail

MEDICARE: MS. REBECCA ELIZABETH DALTON LICSW

MEDICARE: MS. REBECCA ELIZABETH DALTON LICSW
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 Worker3826896DC

General Provider Information

NPI Number : 1407985799
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA ELIZABETH DALTON LICSW
Provider Business Mailing Address
First Line : 504 DARTMOUTH AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-4261
Country : US
Telephone Number : 202-232-9100
Fax Number :
Provider Business Practice Location Address
First Line : 2607 CONNECTICUT AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20008-1522
Country : US
Telephone Number : 202-232-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/09/2007

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