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General NPI Number Information
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NPI Number | 1033886551
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Entity Type | Individual
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Provider Name | LEON DWIGHT DALEY
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Gender | Male
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 2664 SW BEAR PAW TRL
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City | PALM CITY
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State | FL
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Zip | 34990-7941
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Country | US
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Telephone | 386-212-8988
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Fax |
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Provider Business Mailing Address
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Address Line | 2664 SW BEAR PAW TRL
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City | PALM CITY
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State | FL
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Zip | 34990-7941
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Country | US
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Telephone | 386-212-8988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA17951
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License Number State |
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