Provider Demographics
NPI:1528332137
Name:RAUDY, DANIEL (MSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:RAUDY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:RAUDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:118 CONAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-7306
Mailing Address - Country:US
Mailing Address - Phone:530-327-9509
Mailing Address - Fax:
Practice Address - Street 1:118 CONAWAY AVE
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7306
Practice Address - Country:US
Practice Address - Phone:530-327-9509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker