Healthcare Provider Details

I. General information

NPI: 1578596714
Provider Name (Legal Business Name): ERNEST GARLINGTON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 OLD MTN ROAD
MARION CT
06444
US

IV. Provider business mailing address

PO BOX 597
MARION CT
06444-0597
US

V. Phone/Fax

Practice location:
  • Phone: 860-621-0187
  • Fax:
Mailing address:
  • Phone: 860-621-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001206
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: