Provider Demographics
NPI:1528798089
Name:GARLINGTON, DRISANA CECILIA
Entity type:Individual
Prefix:
First Name:DRISANA
Middle Name:CECILIA
Last Name:GARLINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E LURAY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-4425
Mailing Address - Country:US
Mailing Address - Phone:215-834-5245
Mailing Address - Fax:
Practice Address - Street 1:6 COUNTRY WALK
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-5326
Practice Address - Country:US
Practice Address - Phone:475-269-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool