Organization
TRANQUIL MOMENTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE DENHAM PHD, PMHNP, BC (OWNER)
(606) 669-1507
Entity
Organization
Contact information
Practice address
704 E MAIN ST, STANFORD, KY 40484-1405
(606) 365-7007
(606) 365-7001
Mailing address
PO BOX 661, STANFORD, KY 40484-0661
(606) 365-7007
(606) 365-7001
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2829P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1179045
CHA
KY
05
—
78028297
—
KY
Enumeration date
06/26/2006
Last updated
08/22/2020
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