Provider Demographics
NPI:1184052060
Name:GARNER, THOMASINA
Entity type:Individual
Prefix:
First Name:THOMASINA
Middle Name:
Last Name:GARNER
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 1:13234 SHAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9500
Mailing Address - Country:US
Mailing Address - Phone:202-746-5823
Mailing Address - Fax:
Practice Address - Street 1:3101 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3302
Practice Address - Country:US
Practice Address - Phone:202-939-6680
Practice Address - Fax:202-576-9158
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLI2001161041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool