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NPI Code Detail

MEDICARE: NICOLE GARRISON

MEDICARE:   NICOLE  GARRISON
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1477909554
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE GARRISON
Provider Business Mailing Address
First Line : 1 WINDING DR
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-2907
Country : US
Telephone Number : 267-787-6600
Fax Number :
Provider Business Practice Location Address
First Line : 1 WINDING DR
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-2907
Country : US
Telephone Number : 267-787-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2016
Last Update Date : 12/04/2017

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Directions to “ NICOLE GARRISON ” Practice Location

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