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General NPI Number Information
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NPI Number | 1790025351
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Entity Type | Individual
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Provider Name | JOLENE LYNN DALY LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 2020 COFFEE RD STE A5
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-585-5345
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Fax | 855-300-4285
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Provider Business Mailing Address
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Address Line | 2020 COFFEE RD STE A5
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City | MODESTO
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State | CA
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Zip | 95355-2407
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Country | US
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Telephone | 209-585-5345
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Fax | 855-300-4285
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT95735
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License Number State | CA
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