Individual
DEREK J DALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
56 SOUTH MAIN ST, LOA, UT 84747
(801) 358-2974
Mailing address
56 SOUTH MAIN, LOA, UT 84747
(801) 358-2974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8870520-6005
UT
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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