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General NPI Number Information
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NPI Number | 1871017319
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Entity Type | Individual
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Provider Name | KATHY GARDNER ED.D, LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 438 W. SEED FARM ROAD
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City | SACATON
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State | AZ
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Zip | 85283
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Country | US
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Telephone | 520-796-2600
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Fax | 520-796-2649
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Provider Business Mailing Address
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Address Line | PO BOX 1491
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City | MARICOPA
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State | AZ
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Zip | 85139-1370
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Country | US
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Telephone | 602-505-0635
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LMSW-21444
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License Number State | AZ
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