Provider Demographics
NPI:1720863632
Name:GARVIN, AMBERLY PAIGE
Entity Type:Individual
Prefix:
First Name:AMBERLY
Middle Name:PAIGE
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 1:240 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3136
Mailing Address - Country:US
Mailing Address - Phone:979-575-6856
Mailing Address - Fax:
Practice Address - Street 1:17774 CYPRESS ROSEHILL RD STE 400
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7815
Practice Address - Country:US
Practice Address - Phone:281-205-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional