Individual
DAKSHANIQUE GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1331 UNION AVE STE 1012, MEMPHIS, TN 38104-7509
(901) 244-2233
Mailing address
PO BOX 34761, BARTLETT, TN 38184-0761
(901) 282-9732
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q055545
BLUE CROSS BLUE SHIELD
TN
Enumeration date
09/11/2020
Last updated
09/11/2020
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