Individual
DR. SHAENA Y GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D, HSPP
Contact information
Practice address
6600 VAN AALST BLVD, COLUMBUS, GA 31905-2102
(762) 408-2273
Mailing address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(317) 496-3728
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20042431A
IN
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20077810A
—
IN
Enumeration date
06/28/2010
Last updated
06/11/2024
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