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General NPI Number Information
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NPI Number | 1720296965
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Entity Type | Individual
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Provider Name | CORALINE DAHLIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 819 GRAND ST
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City | BROOKLYN
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State | NY
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Zip | 11211-5001
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Country | US
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Telephone | 917-374-3237
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 286136 YORKVILLE STATION
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City | NEW YORK
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State | NY
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Zip | 10128-0002
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Country | US
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Telephone | 917-374-3237
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 069442-1
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License Number State | NY
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