Provider Demographics
NPI:1417980657
Name:DAILEY, SHARON LEE (MSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LEE
Last Name:DAILEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392021
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-0034
Mailing Address - Country:US
Mailing Address - Phone:313-580-2300
Mailing Address - Fax:
Practice Address - Street 1:3974 ANNISTOWN RD
Practice Address - Street 2:APT 807
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-8476
Practice Address - Country:US
Practice Address - Phone:313-580-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010173931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical