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General NPI Number Information
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NPI Number | 1427186675
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Entity Type | Individual
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Provider Name | JONATHAN MICHAEL GARRISON PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 11145 TULLAHOMA HWY
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City | TULLAHOMA
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State | TN
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Zip | 37388-6016
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Country | US
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Telephone | 931-454-9994
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Fax | 931-455-5086
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Provider Business Mailing Address
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Address Line | PO BOX 820
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City | TULLAHOMA
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State | TN
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Zip | 37388-0820
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Country | US
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Telephone | 931-454-9994
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Fax | 931-455-5086
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | P0000002359
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License Number State | TN
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