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Individual
CONNIE C. GARDNER
Active
Individual
CONNIE C. GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701004280
VA
251S00000X
Community/Behavioral Health Agency
2665
VA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0701004280
VA
Other
Enumeration date
06/10/2008
Last updated
06/18/2026
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