MEDICARE: MRS. KRISTIN ANNE GARLING MA, CCC-SLP

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	12110262	MI

General Provider Information

NPI Number	:	1538419486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN ANNE GARLING MA, CCC-SLP

Provider Business Mailing Address
First Line	:	1317 WAVERLY AVE
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2254
Country	:	US
Telephone Number	:	269-598-4711
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 WAVERLY AVE
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2254
Country	:	US
Telephone Number	:	269-598-4711
Fax Number	:

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

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	09/18/2012

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