Provider Demographics
NPI:1730995770
Name:DALY, ANTHONY ROBERT
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROBERT
Last Name:DALY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 MILLHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2668
Mailing Address - Country:US
Mailing Address - Phone:410-490-7674
Mailing Address - Fax:
Practice Address - Street 1:2144 MILLHAVEN DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2668
Practice Address - Country:US
Practice Address - Phone:410-490-7674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician