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General NPI Number Information
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NPI Number | 1265318059
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Entity Type | Individual
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Provider Name | TRACEY RUTH GARNER EDS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 100 N MAIN ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4529
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Country | US
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Telephone | 478-919-7181
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Fax |
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Provider Business Mailing Address
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Address Line | 318 OLD POINT RD
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City | CHESTER
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State | MD
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Zip | 21619-2328
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Country | US
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Telephone | 478-919-7181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 33826
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | PGP-0702894
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License Number State | VA
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