NPI 1003189747

Clovis Everet Daley, LICSW

Practitioner Case Manager/Care Coordinator Aquasco, MD

Practice location

Address: 17102 Eagle Harbor Rd, Aquasco, MD 20608-9566
Phone: (301) 266-0340

Registered specialties

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X Licence LC50079299 (DC)

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Registry record

NPI: 1003189747
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Feb 2012
Record last updated: 10 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.