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NPI Code Detail

MEDICARE: CYNTHIA GARAVAGLIA LMSW, ACSW

MEDICARE: CYNTHIA GARAVAGLIA LMSW, ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801062756MI

General Provider Information

NPI Number : 1043326796
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA GARAVAGLIA LMSW, ACSW
Provider Business Mailing Address
First Line : 3031 COMMERCE DR STE B
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3820
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3031 COMMERCE DR STE B
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3820
Country : US
Telephone Number : 810-987-6911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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