Basic Information
| Provider Information | |||||||||
| NPI: | 1538325766 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRISON | ||||||||
| FirstName: | MARGERY | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA, CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2521 GLENN HENDRON DRIVE | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | LIBERTY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640683388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167811001 | ||||||||
| FaxNumber: | 8167920408 | ||||||||
| Practice Location | |||||||||
| Address1: | 2521 GLENN HENDRON DRIVE | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | LIBERTY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640683388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167811001 | ||||||||
| FaxNumber: | 8167920408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 08/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 2001028185 | MO | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.