Provider Demographics
NPI:1760046056
Name:MARY I DALY CLINICAL PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:MARY I DALY CLINICAL PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:I
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:203-710-0090
Mailing Address - Street 1:251 EDWARDS ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3784
Mailing Address - Country:US
Mailing Address - Phone:203-710-0090
Mailing Address - Fax:
Practice Address - Street 1:251 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3784
Practice Address - Country:US
Practice Address - Phone:203-710-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty