Provider Demographics
NPI:1417232281
Name:GARRETT, JULIE K (EDS/LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:GARRETT
Suffix:
Gender:F
Credentials:EDS/LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 763
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-0763
Mailing Address - Country:US
Mailing Address - Phone:864-228-1919
Mailing Address - Fax:864-862-5349
Practice Address - Street 1:1206 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-6018
Practice Address - Country:US
Practice Address - Phone:864-228-1919
Practice Address - Fax:864-862-5349
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4205106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist