Organization
1 VILLAGE 1 CHILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH DALY PH.D. (OWNER)
(321) 209-3259
Entity
Organization
Contact information
Practice address
1257 REAGANS RESERVE BLVD, APOPKA, FL 32712-3008
(321) 209-3259
Mailing address
PO BOX 308, GOTHA, FL 34734-0308
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
102X00000X
Poetry Therapist
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/01/2014
Last updated
02/05/2015
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