Provider Demographics
NPI:1073127700
Name:GARLAND, KEITH ALAN JR
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ALAN
Last Name:GARLAND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CHAPMAN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5415
Mailing Address - Country:US
Mailing Address - Phone:302-956-9188
Mailing Address - Fax:
Practice Address - Street 1:256 CHAPMAN RD STE 203
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5415
Practice Address - Country:US
Practice Address - Phone:302-956-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor