Provider Demographics
NPI:1578895108
Name:GARVIN, TRISHA KAY (MT-BC)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:KAY
Last Name:GARVIN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1102
Mailing Address - Country:US
Mailing Address - Phone:612-644-0818
Mailing Address - Fax:
Practice Address - Street 1:404 1ST ST N
Practice Address - Street 2:
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1102
Practice Address - Country:US
Practice Address - Phone:612-644-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-07
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN08607225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist