Provider Demographics
NPI:1134755341
Name:GARLAND, AMBER RENEE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:RENEE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:RENEE
Other - Last Name:HIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17160 DRAGONFLY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3634
Mailing Address - Country:US
Mailing Address - Phone:317-770-0656
Mailing Address - Fax:
Practice Address - Street 1:17160 DRAGONFLY DR STE 200
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3634
Practice Address - Country:US
Practice Address - Phone:317-770-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001503A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist