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NPI Code Detail

MEDICARE: SUSAN GARRITY BCBA, COBA, LBA

MEDICARE: SUSAN GARRITY BCBA, COBA, LBA
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
1247200000XOther Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1497147623
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN GARRITY BCBA, COBA, LBA
Provider Business Mailing Address
First Line : 2105 LAWRENCE AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number : 419-291-7080
Fax Number :
Provider Business Practice Location Address
First Line : 2105 LAWRENCE AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number : 419-291-7080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2015
Last Update Date : 07/11/2023

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