Healthcare Provider Details

I. General information

NPI: 1871439992
Provider Name (Legal Business Name): ANITA MARIE DALY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 CLIMBING ROSE LN
MATTHEWS NC
28104-6233
US

IV. Provider business mailing address

2113 CLIMBING ROSE LN
MATTHEWS NC
28104-6233
US

V. Phone/Fax

Practice location:
  • Phone: 919-744-6808
  • Fax:
Mailing address:
  • Phone: 919-744-6808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12025227
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: