Provider Demographics
NPI:1396899241
Name:GARNER, MAUREEN VALERIE (PHD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:VALERIE
Last Name:GARNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E WASHINGTON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2017
Mailing Address - Country:US
Mailing Address - Phone:734-622-0445
Mailing Address - Fax:734-528-4155
Practice Address - Street 1:202 E WASHINGTON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2017
Practice Address - Country:US
Practice Address - Phone:734-622-0445
Practice Address - Fax:734-528-4155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007830103TC0700X
OH5096103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2132918Medicaid
OHGACP77461Medicare ID - Type Unspecified