Provider Demographics
NPI:1568768596
Name:GARLAND, MARIA A (QMHP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:A
Last Name:GARLAND
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ANN
Other - Last Name:KISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC, LLMFT, TLLP
Mailing Address - Street 1:2521 SE 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1150
Mailing Address - Country:US
Mailing Address - Phone:503-597-3938
Mailing Address - Fax:503-597-3939
Practice Address - Street 1:2521 SE 74TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1150
Practice Address - Country:US
Practice Address - Phone:503-597-3938
Practice Address - Fax:503-597-3939
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2092957106H00000X
MITLLP L1832600101YM0800X
MILLPC L1845750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist