Provider Demographics
NPI:1720417306
Name:GARRETT, CLAUDIA (LADAC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960B OLD AUSTIN PEAY HWY
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5631
Mailing Address - Country:US
Mailing Address - Phone:901-372-9898
Mailing Address - Fax:901-373-9298
Practice Address - Street 1:2960B OLD AUSTIN PEAY HWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5631
Practice Address - Country:US
Practice Address - Phone:901-372-9898
Practice Address - Fax:901-373-9298
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000001011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)