Healthcare Provider Details

I. General information

NPI: 1144200544
Provider Name (Legal Business Name): JOAN GRIMWOOD ALDAY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3259 CATLIN AVE
QUANTICO VA
22134-5109
US

IV. Provider business mailing address

3259 CATLIN AVE
QUANTICO VA
22134-5109
US

V. Phone/Fax

Practice location:
  • Phone: 703-784-1779
  • Fax: 703-784-1787
Mailing address:
  • Phone: 703-784-1779
  • Fax: 703-784-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0810C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: