Provider Demographics
NPI:1912740051
Name:GARIBAY, AMY LOU
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LOU
Last Name:GARIBAY
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 1:875 HERON DR APT 211
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-7884
Mailing Address - Country:US
Mailing Address - Phone:507-327-2209
Mailing Address - Fax:
Practice Address - Street 1:1400 MADISON AVE STE 322
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5465
Practice Address - Country:US
Practice Address - Phone:507-702-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health