Provider Demographics
NPI:1669927794
Name:GARNER, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 170106
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-8011
Mailing Address - Country:US
Mailing Address - Phone:414-371-1600
Mailing Address - Fax:414-371-2400
Practice Address - Street 1:4550 W BRADLEY RD
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-3713
Practice Address - Country:US
Practice Address - Phone:414-371-1600
Practice Address - Fax:414-371-2400
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1958-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional