Provider Demographics
NPI:1306940812
Name:DAILEY, ANGELA (LMHC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DAILEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-6139
Mailing Address - Country:US
Mailing Address - Phone:352-315-7555
Mailing Address - Fax:352-360-6582
Practice Address - Street 1:3750 LAKE CENTER LOOP
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2211
Practice Address - Country:US
Practice Address - Phone:352-383-2194
Practice Address - Fax:352-383-2193
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health