Healthcare Provider Details

I. General information

NPI: 1659201531
Provider Name (Legal Business Name): MRS. ASHLEY JOANN GARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E LIBERTY AVE
LYONS GA
30436-1559
US

IV. Provider business mailing address

807 JUNGLE RD
VIDALIA GA
30474-8428
US

V. Phone/Fax

Practice location:
  • Phone: 912-515-5026
  • Fax:
Mailing address:
  • Phone: 912-245-3193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: