Provider Demographics
NPI:1174651988
Name:GARRISON, JEFFREY SCOTT (MA)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:GARRISON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MOORING DR
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-2631
Mailing Address - Country:US
Mailing Address - Phone:508-274-4636
Mailing Address - Fax:
Practice Address - Street 1:203 MOORING DR
Practice Address - Street 2:
Practice Address - City:COTUIT
Practice Address - State:MA
Practice Address - Zip Code:02635-2631
Practice Address - Country:US
Practice Address - Phone:508-274-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health