Provider Information for 1205324084
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KURTIS GARVIN LMFT
Sex: Male
NPI: 1205324084
Last Updated: 2018-04-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1205324084 | ||||||||
| Enumeration Date | 2018-04-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 42 BEACH DR PROSPECT, CT 06712-1603 United States Phone: 716-450-4517 | Fax: | ||||||||
| Primary Practice Address | 53 UNQUOWA PL FAIRFIELD, CT 06824-5058 United States Phone: 716-450-4517 | Fax: | ||||||||
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