Provider Demographics
NPI:1952644536
Name:GARZA, LAURA LYN
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYN
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 W CHARLESTON BLVD
Mailing Address - Street 2:#2098
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5407
Mailing Address - Country:US
Mailing Address - Phone:702-743-4070
Mailing Address - Fax:
Practice Address - Street 1:4180 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5074
Practice Address - Country:US
Practice Address - Phone:702-486-6987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health