Provider Demographics
NPI:1992501886
Name:GARRETT, SHERESE BLEECHINGTON
Entity type:Individual
Prefix:DR
First Name:SHERESE
Middle Name:BLEECHINGTON
Last Name:GARRETT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WHITE ROSE TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8335
Mailing Address - Country:US
Mailing Address - Phone:850-284-7209
Mailing Address - Fax:
Practice Address - Street 1:400 WHITE ROSE TRCE
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8335
Practice Address - Country:US
Practice Address - Phone:850-284-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
13571174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator