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General NPI Number Information
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NPI Number | 1609098193
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Entity Type | Individual
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Provider Name | MICHAEL E GARRARD CADC, SCPG, CAC, SCC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 142 GRIGGS ST
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City | WATERBURY
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State | CT
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Zip | 06704-3110
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Country | US
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Telephone | 203-574-1419
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Fax | 203-578-4180
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Provider Business Mailing Address
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Address Line | 141 E MAIN ST
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City | WATERBURY
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State | CT
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Zip | 06702-2310
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Country | US
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Telephone | 203-574-9000
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Fax | 203-574-9006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 621
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License Number State | CT
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