Healthcare Provider Details

I. General information

NPI: 1992667703
Provider Name (Legal Business Name): ALEILA GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CARRIEBROOKE DR
STEPHENS CITY VA
22655-6000
US

IV. Provider business mailing address

130 CARRIEBROOKE DR
STEPHENS CITY VA
22655-6000
US

V. Phone/Fax

Practice location:
  • Phone: 804-658-4509
  • Fax:
Mailing address:
  • Phone: 804-658-4509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: