Provider Demographics
NPI:1326813817
Name:GARRETT, LANISHA M (DC)
Entity Type:Individual
Prefix:
First Name:LANISHA
Middle Name:M
Last Name:GARRETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SYMPHONY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-5027
Mailing Address - Country:US
Mailing Address - Phone:480-322-0071
Mailing Address - Fax:
Practice Address - Street 1:711 W 40TH ST STE 156
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2143
Practice Address - Country:US
Practice Address - Phone:410-235-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor