Provider Demographics
NPI:1962187609
Name:GARRETT, ALIDA MARIE
Entity type:Individual
Prefix:
First Name:ALIDA
Middle Name:MARIE
Last Name:GARRETT
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 1:12 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01436-1113
Mailing Address - Country:US
Mailing Address - Phone:978-895-5265
Mailing Address - Fax:
Practice Address - Street 1:2033 MAIN ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-3535
Practice Address - Country:US
Practice Address - Phone:978-249-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health