Provider Demographics
NPI:1699898379
Name:GARNER, GLORIA ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:ANN
Last Name:GARNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:GLORIA
Other - Middle Name:ANN
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2129 WATERTOWN PL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2115
Mailing Address - Country:US
Mailing Address - Phone:931-552-9202
Mailing Address - Fax:931-551-9202
Practice Address - Street 1:2150 WILMA RUDOLPH BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6670
Practice Address - Country:US
Practice Address - Phone:931-542-2168
Practice Address - Fax:931-542-2206
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000001494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist