Provider Demographics
NPI:1023380144
Name:GARDEN, DEBRA ANNE (LLPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNE
Last Name:GARDEN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W UNIVERSITY DR STE C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1852
Mailing Address - Country:US
Mailing Address - Phone:248-601-3111
Mailing Address - Fax:
Practice Address - Street 1:850 W UNIVERSITY DR STE C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1852
Practice Address - Country:US
Practice Address - Phone:248-601-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-05
Last Update Date:2012-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional