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Individual

MS. GWENDOLYN G GARRETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MAOTR

Contact information

Practice address
525 OYSTER POINT RD, SUITE E, NEWPORT NEWS, VA 23602-6014
(757) 269-0430
(757) 269-0432
Mailing address
771 PILOT HOUSE DR, NEWPORT NEWS, VA 23606-1990
(757) 873-2302
(757) 873-2306

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119001200
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1154551935
BCBS (OCCUPATIONAL THERAPY)
VA
05
1255429122
VA
01
7150820
AETNA
VA
01
P00733181
MEDICARE RAILROAD
VA
Enumeration date
10/10/2006
Last updated
09/23/2009
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