Healthcare Provider Details

I. General information

NPI: 1841506714
Provider Name (Legal Business Name): GENEVIEVE ANN DAILEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2010
Last Update Date: 08/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2568 PELTON HILL RD
NEW ALBANY PA
18833-8970
US

IV. Provider business mailing address

2568 PELTON HILL RD
NEW ALBANY PA
18833-8970
US

V. Phone/Fax

Practice location:
  • Phone: 570-363-2659
  • Fax:
Mailing address:
  • Phone: 570-363-2659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC000381
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: