Provider Demographics
NPI:1477048007
Name:GARRARD, MINDY
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:GARRARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:BOGARDUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 INDIANOLA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-2118
Mailing Address - Country:US
Mailing Address - Phone:614-294-2661
Mailing Address - Fax:
Practice Address - Street 1:1515 INDIANOLA AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-2118
Practice Address - Country:US
Practice Address - Phone:614-294-2661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional