Provider Demographics
NPI:1326207812
Name:DALY, CONSTANCE VANCOTT (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:VANCOTT
Last Name:DALY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 TIMMY TRAIL
Mailing Address - Street 2:PO BOX 927
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-0927
Mailing Address - Country:US
Mailing Address - Phone:828-400-1060
Mailing Address - Fax:
Practice Address - Street 1:162 TIMMY TRAIL
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-0927
Practice Address - Country:US
Practice Address - Phone:828-627-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist