Provider Demographics
NPI:1699754549
Name:DALEY, DORANNA PUALILILEHUA (LCSW)
Entity type:Individual
Prefix:
First Name:DORANNA
Middle Name:PUALILILEHUA
Last Name:DALEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DORANNA
Other - Middle Name:P
Other - Last Name:DALEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5312 W 3830 S
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2744
Mailing Address - Country:US
Mailing Address - Phone:801-718-6474
Mailing Address - Fax:
Practice Address - Street 1:2588 W 2365 S
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-1249
Practice Address - Country:US
Practice Address - Phone:801-978-4516
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT528919735011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical