MEDICARE: MRS. MICHELLE B GARRISON M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	020771L	MD

General Provider Information

NPI Number	:	1053926022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE B GARRISON M.S.

Provider Business Mailing Address
First Line	:	7433 SWAN POINT WAY
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-5056
Country	:	US
Telephone Number	:	443-465-5849
Fax Number	:

Provider Business Practice Location Address
First Line	:	7433 SWAN POINT WAY
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-5056
Country	:	US
Telephone Number	:	443-465-5849
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	09/15/2020

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Directions to “ MRS. MICHELLE B GARRISON M.S.” Practice Location

Language	Start Address	Practice Location

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