Provider Demographics
NPI:1093817769
Name:LAIRD-GARLAND, MARILYN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:LAIRD-GARLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 WURZBACH RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3832
Mailing Address - Country:US
Mailing Address - Phone:210-846-7904
Mailing Address - Fax:210-558-7149
Practice Address - Street 1:6914 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3832
Practice Address - Country:US
Practice Address - Phone:210-846-7904
Practice Address - Fax:210-558-7149
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX099671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5033-01OtherPACIFICARE
TXS0095POtherBLUC CROSS BLUE SHIELD
TX00S95PMedicare ID - Type UnspecifiedLCSW