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Individual

JACQUELYN A GARNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
3840 HULEN ST, HTN CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Mailing address
PO BOX 2603, HTN CLIENT ACCOUNTING, FORT WORTH, TX 76113-2603
(817) 569-4396
(817) 569-4517

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109480
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
194616201
TX
01
8T5168
BCBS
TX
Enumeration date
09/03/2008
Last updated
11/14/2011
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