Individual
LYDIA LEE DALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, BC
Contact information
Practice address
223 N. ANDERSON DRIVE, SWAINSBORO, GA 30401
(478) 289-2530
(478) 289-2532
Mailing address
P O BOX 1259, 223 N. ANDERSON DRIVE, SWAINSBORO, GA 30401
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN048295
GA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
RN048295
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606383B
—
GA
05
—
1952451262
—
GA
Enumeration date
01/24/2007
Last updated
08/29/2012
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