Provider Demographics
NPI:1659308039
Name:GARRETT, MICHELLE HAHN (MS)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:HAHN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 ADAMS TRL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-4321
Mailing Address - Country:US
Mailing Address - Phone:405-476-2423
Mailing Address - Fax:
Practice Address - Street 1:708 W 15TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3652
Practice Address - Country:US
Practice Address - Phone:405-476-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLMFT 801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health