Provider Demographics
NPI:1508603838
Name:GARZA, VANESSA ANNE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANNE
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:ANNE
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:4957 EASTWOOD GREENS ST UNIT 107
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-3743
Mailing Address - Country:US
Mailing Address - Phone:239-219-3744
Mailing Address - Fax:
Practice Address - Street 1:3763 EVANS AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9302
Practice Address - Country:US
Practice Address - Phone:239-275-3222
Practice Address - Fax:239-332-0287
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT5037106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist