Provider Demographics
NPI:1033493960
Name:DALEY, MARY CLAIRE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CLAIRE
Last Name:DALEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2630
Mailing Address - Country:US
Mailing Address - Phone:716-834-1708
Mailing Address - Fax:
Practice Address - Street 1:18 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2630
Practice Address - Country:US
Practice Address - Phone:716-834-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006381235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006381OtherNYS LICENSE