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Individual

MISS DHURANIQUE DAPHNE LAURA FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1120 N OCOEE ST, CLEVELAND, TN 37311-4475
(423) 380-8255
Mailing address
260 25TH ST NE APT 1604, CLEVELAND, TN 37311-3972
(423) 813-9579

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
05/12/2023
Last updated
05/12/2023
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