Provider Demographics
NPI:1912080284
Name:GARRISON, MARY B (RNC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:B
Last Name:GARRISON
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:B
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:21 PAYTON ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905
Mailing Address - Country:US
Mailing Address - Phone:401-941-5889
Mailing Address - Fax:
Practice Address - Street 1:70 MINNESOTA AVE
Practice Address - Street 2:THE RENT CENTER HILLSGROVE HOUSE
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888
Practice Address - Country:US
Practice Address - Phone:401-732-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN23460163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health