Provider Demographics
NPI:1982421368
Name:EDINGER, GARRETT ETHAN (MS, CGC)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:ETHAN
Last Name:EDINGER
Suffix:
Gender:M
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14567 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9499
Mailing Address - Country:US
Mailing Address - Phone:440-632-5532
Mailing Address - Fax:440-632-1697
Practice Address - Street 1:14567 MADISON RD
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9499
Practice Address - Country:US
Practice Address - Phone:440-632-5532
Practice Address - Fax:440-632-1697
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7201000577170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS