Provider Demographics
NPI:1932745353
Name:DALY, PATSY ANN
Entity Type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:ANN
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 1:201 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-8786
Mailing Address - Country:US
Mailing Address - Phone:989-251-9407
Mailing Address - Fax:989-344-0285
Practice Address - Street 1:201 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-8786
Practice Address - Country:US
Practice Address - Phone:989-251-9407
Practice Address - Fax:989-344-0285
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI802307798172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker