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General NPI Number Information
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NPI Number | 1063031482
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Entity Type | Individual
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Provider Name | HANNAH TERESA DALY
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 09/13/2020
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Provider Practice Location Address
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Address Line | 2150 W LAWRENCE AVE STE A
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City | CHICAGO
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State | IL
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Zip | 60625-1582
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Country | US
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Telephone | 773-887-6447
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Fax |
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Provider Business Mailing Address
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Address Line | 17908 IROQUOIS TRCE
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City | TINLEY PARK
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State | IL
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Zip | 60477-2603
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Country | US
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Telephone | 708-921-9845
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.016272
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License Number State | IL
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