Provider Demographics
NPI:1285686352
Name:GARNET, KATHLEEN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:E
Last Name:GARNET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-5307
Mailing Address - Country:US
Mailing Address - Phone:860-560-6912
Mailing Address - Fax:860-760-6912
Practice Address - Street 1:381 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-5307
Practice Address - Country:US
Practice Address - Phone:860-560-6912
Practice Address - Fax:860-760-6912
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2201103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
113771808OtherTIN