Healthcare Provider Details

I. General information

NPI: 1902739956
Provider Name (Legal Business Name): LAURA GARVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37303 HARVEST AVE
AVON OH
44011-2803
US

IV. Provider business mailing address

37303 HARVEST AVE
AVON OH
44011-2803
US

V. Phone/Fax

Practice location:
  • Phone: 440-847-8505
  • Fax:
Mailing address:
  • Phone: 440-847-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2608040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: