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General NPI Number Information
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NPI Number | 1497329379
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Entity Type | Individual
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Provider Name | DAITON STONE BROLIN LCSWA
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Gender | Male
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 7330 CHAPEL HILL RD STE 203
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City | RALEIGH
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State | NC
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Zip | 27607-5042
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Country | US
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Telephone | 910-494-8486
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Fax | 919-673-0438
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Provider Business Mailing Address
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Address Line | 7406 CHAPEL HILL RD STE J
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City | RALEIGH
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State | NC
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Zip | 27607-5039
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Country | US
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Telephone | 910-494-8486
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Fax | 919-573-0438
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P020841
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License Number State | NC
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