Healthcare Provider Details

I. General information

NPI: 1235069568
Provider Name (Legal Business Name): DAPHNE HARGIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5842 HIGHWAY 30
BENTON TN
37307-4734
US

IV. Provider business mailing address

9020 WACONDA SHORE DR
CHATTANOOGA TN
37416-1330
US

V. Phone/Fax

Practice location:
  • Phone: 423-375-4173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: