Provider Demographics
NPI:1538804216
Name:DALEY, TATYANA (CASAC)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 AARON CT
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2966
Mailing Address - Country:US
Mailing Address - Phone:845-834-7300
Mailing Address - Fax:845-802-0038
Practice Address - Street 1:500 AARON CT
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2966
Practice Address - Country:US
Practice Address - Phone:845-834-7300
Practice Address - Fax:845-802-0038
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)