Healthcare Provider Details

I. General information

NPI: 1699315663
Provider Name (Legal Business Name): HEATHER GARRETT MED, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6460 CENTERVILLE BUSINESS PKWY
CENTERVILLE OH
45459-2633
US

IV. Provider business mailing address

6460 CENTERVILLE BUSINESS PKWY
CENTERVILLE OH
45459-2633
US

V. Phone/Fax

Practice location:
  • Phone: 937-723-6453
  • Fax:
Mailing address:
  • Phone: 937-723-6453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46345
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOBA.00769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: