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NPI Code Detail

MEDICARE: MS. MARILYN ROSE GARNER LCSW

MEDICARE: MS. MARILYN ROSE GARNER LCSW
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
11041C0700XClinical Social WorkerL1127OR

General Provider Information

NPI Number : 1447233846
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARILYN ROSE GARNER LCSW
Provider Business Mailing Address
First Line : PO BOX 579
Second Line :
City : CORVALLIS
State : OR
Zip : 97339-0579
Country : US
Telephone Number : 541-766-6151
Fax Number : 541-766-6186
Provider Business Practice Location Address
First Line : 530 NW 27TH ST
Second Line :
City : CORVALLIS
State : OR
Zip : 97330-5223
Country : US
Telephone Number : 541-766-6151
Fax Number : 541-766-6186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 07/08/2007

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