Provider Demographics
NPI:1801395843
Name:GARNETT, SHEILA YVETTE (BA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:YVETTE
Last Name:GARNETT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 HISTORIC DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1358
Mailing Address - Country:US
Mailing Address - Phone:518-768-1702
Mailing Address - Fax:
Practice Address - Street 1:2210 GOLDSMITH LN STE 221B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1082
Practice Address - Country:US
Practice Address - Phone:518-768-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator