Provider Demographics
NPI:1790957264
Name:GAUDET-GARRETT, TARYN E
Entity Type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:E
Last Name:GAUDET-GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 RODEO DRIVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28356-8710
Mailing Address - Country:US
Mailing Address - Phone:512-623-0004
Mailing Address - Fax:512-623-0004
Practice Address - Street 1:2430 RODEO DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NC
Practice Address - Zip Code:28356-8710
Practice Address - Country:US
Practice Address - Phone:512-623-0004
Practice Address - Fax:512-623-0004
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)