Healthcare Provider Details
I. General information
NPI: 1306235528
Provider Name (Legal Business Name): ASHLEY DALY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/12/2015
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1048 WILDWOOD CENTRE DR STE 207
COLUMBIA SC
29229-8420
US
IV. Provider business mailing address
1321 MURFREESBORO PIKE STE 702
NASHVILLE TN
37217-2679
US
V. Phone/Fax
- Phone: 803-999-3752
- Fax:
- Phone: 615-724-4722
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225C00000X |
| Taxonomy | Rehabilitation Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | RBT-18-67284 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: