Provider Demographics
NPI:1346495306
Name:DAY, RONALD DALE (LCSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DALE
Last Name:DAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2430
Mailing Address - Country:US
Mailing Address - Phone:435-259-6131
Mailing Address - Fax:
Practice Address - Street 1:198 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2430
Practice Address - Country:US
Practice Address - Phone:435-259-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT121659-35011041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical