Healthcare Provider Details

I. General information

NPI: 1548179377
Provider Name (Legal Business Name): SCOTT DAILEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WAGON WHEEL DR
SICKLERVILLE NJ
08081-4802
US

IV. Provider business mailing address

15 WAGON WHEEL DR
SICKLERVILLE NJ
08081-4802
US

V. Phone/Fax

Practice location:
  • Phone: 609-661-1039
  • Fax:
Mailing address:
  • Phone: 609-661-1039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2847198
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: