Individual
TANEQUA DANIELLE SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
103 S AVALON ST, WEST MEMPHIS, AR 72301-4165
(870) 702-7657
Mailing address
7788 LAKE CROSS DR E, MEMPHIS, TN 38125-2835
(901) 205-6141
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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