Provider Demographics
NPI:1609367473
Name:GARMIRIAN, PATRICIA PACKARD (MED, PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:PACKARD
Last Name:GARMIRIAN
Suffix:
Gender:F
Credentials:MED, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 INDIAN PIPE LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3432
Mailing Address - Country:US
Mailing Address - Phone:413-537-8725
Mailing Address - Fax:
Practice Address - Street 1:14 INDIAN PIPE LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3432
Practice Address - Country:US
Practice Address - Phone:413-537-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-28
Last Update Date:2018-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4791-PY-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist