Provider Demographics
NPI:1760920912
Name:GARZA, MARAYAH (LMSW)
Entity Type:Individual
Prefix:
First Name:MARAYAH
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 1:22939 MARLBORO ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1888
Mailing Address - Country:US
Mailing Address - Phone:313-676-1725
Mailing Address - Fax:
Practice Address - Street 1:22939 MARLBORO ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1888
Practice Address - Country:US
Practice Address - Phone:313-676-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010988921041C0700X
MI6801109474104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical