MEDICARE: MIGUELINA DALTON

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	104100000X	Social Worker	SW135259	PA
2	1041C0700X	Clinical Social Worker	CW021838	PA

General Provider Information

NPI Number	:	1942783493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUELINA DALTON

Provider Business Mailing Address
First Line	:	1771 WILDERNESS RD
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-9324
Country	:	US
Telephone Number	:	845-304-5189
Fax Number	:

Provider Business Practice Location Address
First Line	:	1771 WILDERNESS RD
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-9324
Country	:	US
Telephone Number	:	845-304-5189
Fax Number	:

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	05/26/2026

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Directions to “ MIGUELINA DALTON ” Practice Location

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