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NPI Code Detail

MEDICARE: MS. MARY KATHRYN GARRETT LCSW

MEDICARE:  MS. MARY KATHRYN GARRETT  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLSW3430TN

General Provider Information

NPI Number : 1659420941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY KATHRYN GARRETT LCSW
Provider Business Mailing Address
First Line : 4501 HIXSON PIKE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37343
Country : US
Telephone Number : 423-877-2010
Fax Number :
Provider Business Practice Location Address
First Line : 4501 HIXSON PIKE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37343
Country : US
Telephone Number : 423-877-2010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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Directions to “ MS. MARY KATHRYN GARRETT LCSW” Practice Location

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