Basic Information
| Provider Information | |||||||||
| NPI: | 1003153610 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRISON | ||||||||
| FirstName: | MEDLINDA | ||||||||
| MiddleName: | S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1906 HIGHWAY 521 BYP S | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297207579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8035818311 | ||||||||
| FaxNumber: | 8033297141 | ||||||||
| Practice Location | |||||||||
| Address1: | 2230E MAIN STREET | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033289600 | ||||||||
| FaxNumber: | 8033297141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2013 | ||||||||
| LastUpdateDate: | 01/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.