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General NPI Number Information
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NPI Number | 1164622544
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Entity Type | Organization
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Legal Business Name | ANGELA N GARZA LCSW CCM PSC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 13117 EASTPOINT PARK BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40223-4193
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Country | US
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Telephone | 502-224-0987
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Fax |
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Provider Business Mailing Address
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Address Line | 10725 HOBBS STATION RD
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City | LOUISVILLE
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State | KY
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Zip | 40223-2674
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Country | US
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Telephone | 502-224-0987
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANGELA N GARZA
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Credential | LCSW CCM
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Telephone | 502-224-0987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004093A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2044
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License Number State | KY
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