Provider Demographics
NPI:1285616011
Name:DALTON, ROSEMARY DUNN (MSW)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:DUNN
Last Name:DALTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SLEEPY HOLLOW ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1207
Mailing Address - Country:US
Mailing Address - Phone:541-488-2637
Mailing Address - Fax:541-858-5441
Practice Address - Street 1:208 SLEEPY HOLLOW ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1207
Practice Address - Country:US
Practice Address - Phone:541-488-2637
Practice Address - Fax:541-858-5441
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000THLGNMedicare ID - Type Unspecified