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General NPI Number Information
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NPI Number | 1912558164
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Entity Type | Organization
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Legal Business Name | DREAMWALKER LM.S.W. PLLC
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 09/27/2019
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Provider Practice Location Address
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Address Line | 11 ASTON VILLA
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City | NORTH CHILI
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State | NY
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Zip | 14514-9820
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Country | US
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Telephone | 585-507-9250
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Fax | 585-571-4749
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Provider Business Mailing Address
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Address Line | 11 ASTON VILLA
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City | NORTH CHILI
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State | NY
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Zip | 14514-9820
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Country | US
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Telephone | 585-507-9250
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Fax | 585-571-4749
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Authorized Official
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Title or Position | OWNER/SOCIAL WORKER
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Name | MS. STACIE LYNN DAILEY
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Credential | L.M.S.W.
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Telephone | 585-507-9250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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