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NPI Code Detail

MEDICARE: STEPHANIE MARIE GARKOW

MEDICARE:   STEPHANIE MARIE GARKOW
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
1103K00000XBehavior AnalystCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188-2277785OTHERCAABA THERAPY

General Provider Information

NPI Number : 1851813596
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MARIE GARKOW
Provider Business Mailing Address
First Line : 980 W 6TH ST
Second Line :
City : ONTARIO
State : CA
Zip : 91762-1208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 77711 FLORA RD STE 327
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-4103
Country : US
Telephone Number : 626-313-8421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2017
Last Update Date : 11/21/2023

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Directions to “ STEPHANIE MARIE GARKOW ” Practice Location

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