Provider Demographics
NPI:1700928165
Name:HUCKNALL, DAL (LICSW)
Entity Type:Individual
Prefix:
First Name:DAL
Middle Name:
Last Name:HUCKNALL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LAKEHILL AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8226
Mailing Address - Country:US
Mailing Address - Phone:781-424-6249
Mailing Address - Fax:
Practice Address - Street 1:369 MASSACHUSETTS AVE
Practice Address - Street 2:THE ARLINGTON CENTER
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6737
Practice Address - Country:US
Practice Address - Phone:781-424-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1059771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical