Provider Demographics
NPI:1659805802
Name:GARZA, PERLA (LMSW)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 PRAIRIE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-9771
Mailing Address - Country:US
Mailing Address - Phone:616-835-6306
Mailing Address - Fax:
Practice Address - Street 1:1222 PRAIRIE CREEK RD
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-9771
Practice Address - Country:US
Practice Address - Phone:616-835-6306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011082931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty