Individual
DERRISE L GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2 N MAIN ST STE 505, MIAMI, OK 74354-6312
(877) 540-0202
(417) 623-0457
Mailing address
2650 E 32ND ST STE 221, JOPLIN, MO 64804-4300
(417) 623-1381
(417) 623-0457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1031
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200248420A
—
OK
Enumeration date
06/24/2005
Last updated
07/24/2009
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