Provider Demographics
NPI:1245357045
Name:GARNER, WANDA DOWELL (LMFT)
Entity type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:DOWELL
Last Name:GARNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MARINE VIEW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2133
Mailing Address - Country:US
Mailing Address - Phone:858-404-0305
Mailing Address - Fax:858-756-9518
Practice Address - Street 1:140 MARINE VIEW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2133
Practice Address - Country:US
Practice Address - Phone:858-404-0305
Practice Address - Fax:858-756-9518
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health