Provider Demographics
NPI:1528891421
Name:DYE, TANJANIQUE (DIRECT CARE WORKER)
Entity type:Individual
Prefix:MRS
First Name:TANJANIQUE
Middle Name:
Last Name:DYE
Suffix:
Gender:F
Credentials:DIRECT CARE WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26541 RICHARDSON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1924
Mailing Address - Country:US
Mailing Address - Phone:313-333-8699
Mailing Address - Fax:
Practice Address - Street 1:1692 GLYNN CT
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1718
Practice Address - Country:US
Practice Address - Phone:313-333-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider