Provider Demographics
NPI:1518208149
Name:GARRETT, DEBBIE SUE (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:SUE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:DEBBIE
Other - Middle Name:SUE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:215 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-2001
Mailing Address - Country:US
Mailing Address - Phone:304-629-2853
Mailing Address - Fax:
Practice Address - Street 1:301 SUMMERS STREET
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-2308
Practice Address - Country:US
Practice Address - Phone:304-309-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2001-0605225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist