Provider Demographics
NPI:1558249037
Name:DAILEY, JODA COLLEEN (LPC, RN)
Entity type:Individual
Prefix:
First Name:JODA
Middle Name:COLLEEN
Last Name:DAILEY
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 WATERS EDGE WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9710
Mailing Address - Country:US
Mailing Address - Phone:989-798-4575
Mailing Address - Fax:
Practice Address - Street 1:5370 MILLER RD STE 21
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1542
Practice Address - Country:US
Practice Address - Phone:810-350-8872
Practice Address - Fax:810-337-9417
Is Sole Proprietor?:No
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401002016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health