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Individual
VANDER J. DALE JR.
Active
Individual
VANDER J. DALE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, LCAC, CATC-IV,
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
87001320A
IN
104100000X
Social Worker
Primary
LSW0000008307
TN
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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