Provider Demographics
NPI:1316646029
Name:GAREY, MAITLAND LEIGH
Entity type:Individual
Prefix:MRS
First Name:MAITLAND
Middle Name:LEIGH
Last Name:GAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAITLAND
Other - Middle Name:LEIGH
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 BLAIR ST
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-9259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 BLAIR ST
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-9259
Practice Address - Country:US
Practice Address - Phone:231-360-6096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula