Provider Demographics
NPI:1568841807
Name:GARNER, TIMOTHY BRIAN (MFT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:BRIAN
Last Name:GARNER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E J ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-3402
Mailing Address - Country:US
Mailing Address - Phone:225-202-8802
Mailing Address - Fax:
Practice Address - Street 1:917 COUNTRY HILLS DR
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2535
Practice Address - Country:US
Practice Address - Phone:225-202-8802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist