Healthcare Provider Details

I. General information

NPI: 1528798089
Provider Name (Legal Business Name): DRISANA CECILIA GARLINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 COUNTRY WALK
SHELTON CT
06484-5326
US

IV. Provider business mailing address

144 E LURAY ST
PHILADELPHIA PA
19120-4425
US

V. Phone/Fax

Practice location:
  • Phone: 475-269-2106
  • Fax:
Mailing address:
  • Phone: 215-834-5245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: