Provider Demographics
NPI:1386956217
Name:GARNER, TANITH ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:TANITH
Middle Name:ELIZABETH
Last Name:GARNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 S ASPEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-4859
Mailing Address - Country:US
Mailing Address - Phone:918-764-9300
Mailing Address - Fax:918-764-9275
Practice Address - Street 1:1129 S ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4859
Practice Address - Country:US
Practice Address - Phone:918-764-9300
Practice Address - Fax:918-764-9275
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical