Provider Demographics
NPI:1285388314
Name:GARRETT, ABIGAIL
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 COUNTY ROAD 2626
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:AR
Mailing Address - Zip Code:72846-7987
Mailing Address - Country:US
Mailing Address - Phone:479-692-1607
Mailing Address - Fax:
Practice Address - Street 1:313 S ROGERS ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3741
Practice Address - Country:US
Practice Address - Phone:479-705-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCIT101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)