Healthcare Provider Details

I. General information

NPI: 1023731312
Provider Name (Legal Business Name): SANDEE GARRETT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 DELL RD
LANDING NJ
07850-1710
US

IV. Provider business mailing address

PO BOX 536
ROCKAWAY NJ
07866-0536
US

V. Phone/Fax

Practice location:
  • Phone: 973-610-6018
  • Fax:
Mailing address:
  • Phone: 973-610-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SANDEE GARRETT
Title or Position: OWNER
Credential: BCBA
Phone: 973-610-6018