Provider Demographics
NPI:1245589944
Name:GARNER, JEREMY LYNDON (BA,BHRS)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:LYNDON
Last Name:GARNER
Suffix:
Gender:M
Credentials:BA,BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 SW 89TH ST
Mailing Address - Street 2:APT 6205
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7905
Mailing Address - Country:US
Mailing Address - Phone:405-308-7757
Mailing Address - Fax:
Practice Address - Street 1:3131 SW 89TH ST
Practice Address - Street 2:APT 6205
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7905
Practice Address - Country:US
Practice Address - Phone:405-308-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health