Individual
LISA GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
32 MILLBRANCH RD, HATTIESBURG, MS 39402-1672
(601) 255-5264
(866) 625-0559
Mailing address
15489 DEDEAUX RD, GULFPORT, MS 39503-2667
(228) 357-5671
(228) 357-5708
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-163753
MS
Other
Enumeration date
04/13/2021
Last updated
11/15/2022
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