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General NPI Number Information
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NPI Number | 1508044892
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Entity Type | Individual
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Provider Name | MS. WENDY SUZANN GARRISON
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Gender | Female
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 285 S 68TH STREET PL SUITE 319
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City | LINCOLN
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State | NE
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Zip | 68510-2572
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Country | US
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Telephone | 402-432-3746
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Fax | 402-323-3399
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Provider Business Mailing Address
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Address Line | 285 S 68TH STREET PL SUITE 319
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City | LINCOLN
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State | NE
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Zip | 68510-2572
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Country | US
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Telephone | 402-432-3746
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Fax | 402-323-3399
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 598
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2749
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License Number State | NE
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