Individual
MRS. BRENDA DENISE HALEY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3272 PRINCETON AVE, MEMPHIS, TN 38112-3114
(901) 864-3742
Mailing address
3272 PRINCETON AVE, MEMPHIS, TN 38112-3114
(901) 864-3742
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
084292842
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084292842
—
TN
05
—
08492842
—
TN
Enumeration date
06/20/2020
Last updated
06/20/2020
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