MEDICARE: MS. MARILYN LAIRD-GARLAND LCSW

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
1	1041C0700X	Clinical Social Worker	09967	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5033-01	OTHER	TX	PACIFICARE
2	S0095P	OTHER	TX	BLUC CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1093817769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN LAIRD-GARLAND LCSW

Provider Business Mailing Address
First Line	:	6914 WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3832
Country	:	US
Telephone Number	:	210-846-7904
Fax Number	:	210-558-7149

Provider Business Practice Location Address
First Line	:	6914 WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3832
Country	:	US
Telephone Number	:	210-846-7904
Fax Number	:	210-558-7149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	01/04/2011

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