MEDICARE: ANGELA DAILEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	255	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083751283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA DAILEY LCSW

Provider Business Mailing Address
First Line	:	221 10TH LN SW
Second Line	:
City	:	FAIRFIELD
State	:	MT
Zip	:	59436-9527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	423 CENTRAL AVE
Second Line	:
City	:	FAIRFIELD
State	:	MT
Zip	:	59436
Country	:	US
Telephone Number	:	406-467-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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