Provider Demographics
NPI:1487731055
Name:DALTON, PATRICIA (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:DALTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 CONNECTICUT AVENUE NW
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-6042
Mailing Address - Country:US
Mailing Address - Phone:202-537-0330
Mailing Address - Fax:703-671-6157
Practice Address - Street 1:4545 CONNECTICUT AVENUE NW
Practice Address - Street 2:SUITE 309
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-6042
Practice Address - Country:US
Practice Address - Phone:202-537-0330
Practice Address - Fax:703-671-6157
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1274103TC0700X
VA0810002025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA073225Medicare ID - Type Unspecified