Provider Demographics
NPI:1437495207
Name:GARREN, DEVON NOELLE (BS)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:NOELLE
Last Name:GARREN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:NOELLE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:211 WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4526
Mailing Address - Country:US
Mailing Address - Phone:931-797-2136
Mailing Address - Fax:
Practice Address - Street 1:211 WAYNE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4526
Practice Address - Country:US
Practice Address - Phone:931-797-2136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7776728104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker