Provider Demographics
NPI:1558587311
Name:DALEY, SHAY E (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:SHAY
Middle Name:E
Last Name:DALEY
Suffix:
Gender:F
Credentials:PHD, HSPP
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 713
Mailing Address - Street 2:291 WASHINGTON ST.
Mailing Address - City:DAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:47941-0713
Mailing Address - Country:US
Mailing Address - Phone:765-449-4522
Mailing Address - Fax:765-449-4522
Practice Address - Street 1:911 N 18TH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2202
Practice Address - Country:US
Practice Address - Phone:765-449-4522
Practice Address - Fax:765-449-4522
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041137A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical