Provider Demographics
NPI:1821725250
Name:GARVIN, MEKHI L
Entity Type:Individual
Prefix:
First Name:MEKHI
Middle Name:L
Last Name:GARVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 HADDONFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-3376
Mailing Address - Country:US
Mailing Address - Phone:856-406-0035
Mailing Address - Fax:
Practice Address - Street 1:4300 HADDONFIELD RD
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-3376
Practice Address - Country:US
Practice Address - Phone:856-406-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician