MEDICARE: REIANNA GARNER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	P1904043	AR

General Provider Information

NPI Number	:	1164782124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REIANNA GARNER LPC

Provider Business Mailing Address
First Line	:	3811 ROGERS AVE STE C7
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3045
Country	:	US
Telephone Number	:	479-430-2300
Fax Number	:	844-430-0199

Provider Business Practice Location Address
First Line	:	3811 ROGERS AVE STE C7
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3045
Country	:	US
Telephone Number	:	479-430-2300
Fax Number	:	844-430-0199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	11/04/2022

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