Provider Demographics
NPI:1811436249
Name:GARNETTE, ALEXIS (BS)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GARNETTE
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 1:1304 ESTATE CIR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5966
Mailing Address - Country:US
Mailing Address - Phone:985-687-3704
Mailing Address - Fax:
Practice Address - Street 1:1304 ESTATE CIR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5966
Practice Address - Country:US
Practice Address - Phone:985-687-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health