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General NPI Number Information
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NPI Number | 1710644067
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Entity Type | Individual
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Provider Name | GARRETT MARPLE
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Gender | Male
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 10454 WHITTINGTON CT
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City | LARGO
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State | FL
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Zip | 33773-1841
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Country | US
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Telephone | 727-605-0463
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 2ND AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713-8911
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Country | US
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Telephone | 301-250-6127
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Fax |
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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 | 30731
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License Number State | MD
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