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General NPI Number Information
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NPI Number | 1639466675
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Entity Type | Individual
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Provider Name | LAURA GARIBAY LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 820 W 21ST ST STE 207
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City | NORFOLK
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State | VA
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Zip | 23517-1514
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Country | US
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Telephone | 757-453-3282
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Fax | 757-257-8447
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Provider Business Mailing Address
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Address Line | 934 HARRINGTON AVE
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City | NORFOLK
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State | VA
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Zip | 23517-1512
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Country | US
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Telephone | 415-937-2409
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Fax | 757-500-7866
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904011728
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License Number State | VA
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