Healthcare Provider Details

I. General information

NPI: 1174053383
Provider Name (Legal Business Name): JENNIFER GARZA LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3657 FERNWOOD LN
MASON MI
48854-9389
US

IV. Provider business mailing address

3657 FERNWOOD LN
MASON MI
48854-9389
US

V. Phone/Fax

Practice location:
  • Phone: 517-763-8448
  • Fax: 833-761-1200
Mailing address:
  • Phone: 517-763-8448
  • Fax: 833-761-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401018053
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: