Provider Demographics
NPI:1275386542
Name:DALE, RASHEEDA NICHOLE (LSW)
Entity Type:Individual
Prefix:
First Name:RASHEEDA
Middle Name:NICHOLE
Last Name:DALE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08110-3644
Mailing Address - Country:US
Mailing Address - Phone:856-916-2640
Mailing Address - Fax:
Practice Address - Street 1:408 WHITE HORSE PIKE
Practice Address - Street 2:AUDUBON
Practice Address - City:NEW JERSEY
Practice Address - State:NJ
Practice Address - Zip Code:08106
Practice Address - Country:US
Practice Address - Phone:856-332-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06788500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker