Individual
TAQUISA HAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4484 CEDAR RIDGE LN, MEMPHIS, TN 38128-7420
(901) 305-3946
Mailing address
4484 CEDAR RIDGE LN, MEMPHIS, TN 38128-7420
(901) 305-3946
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
110443994
TN
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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