Provider Demographics
NPI:1053926022
Name:GARRISON, MICHELLE B (MS)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:B
Last Name:GARRISON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7433 SWAN POINT WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5056
Mailing Address - Country:US
Mailing Address - Phone:443-465-5849
Mailing Address - Fax:
Practice Address - Street 1:7433 SWAN POINT WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5056
Practice Address - Country:US
Practice Address - Phone:443-465-5849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD020771L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist