Provider Demographics
NPI:1730958695
Name:GARRETT, NICOLE V
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:V
Last Name:GARRETT
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 1:1400 WOODLOCH FOREST DR STE 575
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1179
Mailing Address - Country:US
Mailing Address - Phone:281-528-1523
Mailing Address - Fax:281-719-0491
Practice Address - Street 1:1400 WOODLOCH FOREST DR STE 575
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1179
Practice Address - Country:US
Practice Address - Phone:281-528-1523
Practice Address - Fax:281-719-0491
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health