Provider Demographics
NPI:1790186948
Name:QUIGLEY, TANNIELLE MARIE (CSW)
Entity Type:Individual
Prefix:MRS
First Name:TANNIELLE
Middle Name:MARIE
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E ST. GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770
Mailing Address - Country:US
Mailing Address - Phone:435-674-0984
Mailing Address - Fax:435-674-0584
Practice Address - Street 1:770 E ST. GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770
Practice Address - Country:US
Practice Address - Phone:435-674-0984
Practice Address - Fax:435-674-0584
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8693626-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical