Provider Demographics
NPI:1578815536
Name:DALY, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:DALY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4452
Mailing Address - Country:US
Mailing Address - Phone:216-916-9862
Mailing Address - Fax:216-431-4504
Practice Address - Street 1:2295 EAST 55TH STREET
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4452
Practice Address - Country:US
Practice Address - Phone:216-916-9862
Practice Address - Fax:216-431-4504
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker