Provider Demographics
NPI:1750368619
Name:DALY, ANNE GORMLEY (MSW)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:GORMLEY
Last Name:DALY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:162 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1106
Mailing Address - Country:US
Mailing Address - Phone:978-681-0860
Mailing Address - Fax:978-258-9701
Practice Address - Street 1:109 -123 MAIN ST
Practice Address - Street 2:SUITE E2-2
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-681-0860
Practice Address - Fax:978-258-9701
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1045391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO3807Medicare ID - Type Unspecified