Individual
GINA MARVENE GARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
200 4TH AVE W, SHAKOPEE, MN 55379-1220
(952) 496-8401
Mailing address
200 4TH AVE W, SHAKOPEE, MN 55379-1220
(952) 496-8401
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17995
MN
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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