Provider Demographics
NPI:1972828747
Name:GARRETT, ALISON LEANN (BS)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:LEANN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13575 DURANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-7796
Mailing Address - Country:US
Mailing Address - Phone:918-647-5949
Mailing Address - Fax:
Practice Address - Street 1:13575 DURANT HILL RD
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-7796
Practice Address - Country:US
Practice Address - Phone:918-647-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation