Provider Demographics
NPI:1669727533
Name:DAILEY, QUANISHA CHRISTINE
Entity type:Individual
Prefix:
First Name:QUANISHA
Middle Name:CHRISTINE
Last Name:DAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 ROCKY POINT RUN APT A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-7404
Mailing Address - Country:US
Mailing Address - Phone:757-770-1101
Mailing Address - Fax:
Practice Address - Street 1:2237 HOLLY BERRY LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-5605
Practice Address - Country:US
Practice Address - Phone:757-770-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities