Provider Demographics
NPI:1003904343
Name:GARRETT, DOROTHEA A (LPC)
Entity Type:Individual
Prefix:MS
First Name:DOROTHEA
Middle Name:A
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 FLOWOOD DR # 205A
Mailing Address - Street 2:P.O. BOX 321026
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9362
Mailing Address - Country:US
Mailing Address - Phone:601-594-7233
Mailing Address - Fax:
Practice Address - Street 1:2540 FLOWOOD DR
Practice Address - Street 2:SUITE A 205
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9362
Practice Address - Country:US
Practice Address - Phone:601-594-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0928101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health