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NPI Code Detail

MEDICARE: MR. RIC A DALKE LSCSW

MEDICARE: MR. RIC A DALKE LSCSW
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
11041C0700XClinical Social WorkerLSCSW 0703KS

General Provider Information

NPI Number : 1851516496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RIC A DALKE LSCSW
Provider Business Mailing Address
First Line : 901 LYLE AVE
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-5844
Country : US
Telephone Number : 620-271-0511
Fax Number :
Provider Business Practice Location Address
First Line : 531 CAMPUS VIEW ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-7904
Country : US
Telephone Number : 620-276-6470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 07/08/2007

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