Provider Demographics
NPI:1013618917
Name:DALY, BRIANNA
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WILMOR DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1305
Mailing Address - Country:US
Mailing Address - Phone:185-583-2672
Mailing Address - Fax:
Practice Address - Street 1:357 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3284
Practice Address - Country:US
Practice Address - Phone:908-265-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician