Provider Demographics
NPI:1487799755
Name:GARBETT, DIANNA M (LCSW)
Entity type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:M
Last Name:GARBETT
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 1:15301 WARREN SHINGLE ROAD
Mailing Address - Street 2:9 MDOS SGOHF
Mailing Address - City:BEALE AFB
Mailing Address - State:CA
Mailing Address - Zip Code:95903-1907
Mailing Address - Country:US
Mailing Address - Phone:530-634-3423
Mailing Address - Fax:530-634-0670
Practice Address - Street 1:15301 WARREN SHINGLE ROAD
Practice Address - Street 2:9 MDOS SGOHF
Practice Address - City:BEALE AFB
Practice Address - State:CA
Practice Address - Zip Code:95903-1907
Practice Address - Country:US
Practice Address - Phone:530-634-3423
Practice Address - Fax:530-634-0670
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY224OtherLCSW