Provider Demographics
NPI:1255726451
Name:GARVIN, MAGGIE
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:GARVIN
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 1:6318 S HIGLEY RD STE 102
Mailing Address - Street 2:STUDIO 27
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-4329
Mailing Address - Country:US
Mailing Address - Phone:602-736-9599
Mailing Address - Fax:
Practice Address - Street 1:6318 S HIGLEY RD STE 102
Practice Address - Street 2:STUDIO 27
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-4329
Practice Address - Country:US
Practice Address - Phone:602-736-9599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15-1479175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath