Doctor Name: | KELLY A GARZA |
NPI Number: | 1003173766 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW, LCDCIII |
License Number: | S0032203 |
Business Practice Address: | 1212 Cherry St Toledo, OH - 436082906 |
Business Phone Number: | 4196930631 |
Business Fax Number: | |
Mailing Address: | 1212 Cherry St, TOLEDO |
State: | OH |
Postal Code: | 436082906 |
Phone Number: | 4196930631 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2012 |
NPI Last Update Date: | 04/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | S0032203 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |