Individual
DARVIS QUINN GALLAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
(731) 658-6113
(731) 658-6165
Mailing address
119 AFTON DR, CORINTH, MS 38834-8635
(731) 658-6113
(731) 658-6165
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P 1843
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3066307
BCBS PROVIDER NUMBER
TN
Enumeration date
08/29/2006
Last updated
07/09/2007
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