Provider Demographics
NPI:1295529410
Name:GARZON, JUAN ANDRES
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:ANDRES
Last Name:GARZON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2764
Mailing Address - Country:US
Mailing Address - Phone:267-746-1248
Mailing Address - Fax:
Practice Address - Street 1:1210 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2032
Practice Address - Country:US
Practice Address - Phone:215-444-9204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health