Provider Demographics
NPI:1902520133
Name:GARRIDO, EDWIN M
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:M
Last Name:GARRIDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5776 COLLIER FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7535
Mailing Address - Country:US
Mailing Address - Phone:702-260-4512
Mailing Address - Fax:
Practice Address - Street 1:2860 E FLAMINGO RD STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5270
Practice Address - Country:US
Practice Address - Phone:702-202-0291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst