Basic Information
Provider Information
NPI: 1871699918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARNER
FirstName: SHANNON
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: M.S., C.G.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MCCARTHY
OtherFirstName: SHANNON
OtherMiddleName: MARIE
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 700 CHILDRENS DR # H235
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 700 CHILDRENS DR # H235
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber: 6147223540
FaxNumber: 6147223546
Other Information
ProviderEnumerationDate: 09/16/2006
LastUpdateDate: 09/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
170300000X2005095OHY Other Service ProvidersGenetic Counselor, MS 

No ID Information.


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