Provider Demographics
NPI:1437650421
Name:GARNER, ANDRE C (MS, BCBA)
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:C
Last Name:GARNER
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11013 KEMPSFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-2506
Mailing Address - Country:US
Mailing Address - Phone:860-287-1252
Mailing Address - Fax:
Practice Address - Street 1:13310 S RIDGE DR STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4962
Practice Address - Country:US
Practice Address - Phone:704-945-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-24-73750103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst