Provider Demographics
NPI:1598998106
Name:GARNER, DANA (BCBA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:BCBA
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 5082
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702-0882
Mailing Address - Country:US
Mailing Address - Phone:570-279-8090
Mailing Address - Fax:
Practice Address - Street 1:309 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702-7235
Practice Address - Country:US
Practice Address - Phone:570-279-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-29
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031295OtherBCBA