Individual
MRS. IDA MARIA DACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
120 BANJO LN, CENTREVILLE, MD 21617-1002
(410) 758-2211
(410) 758-1223
Mailing address
PO BOX 718, CENTREVILLE, MD 21617-0718
(410) 758-2211
(410) 758-1223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00438500
NJ
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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