Provider Demographics
NPI:1174306906
Name:MARSHALL-GARZA, AVA GREER (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:AVA
Middle Name:GREER
Last Name:MARSHALL-GARZA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39311 N LUKE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5587
Mailing Address - Country:US
Mailing Address - Phone:480-310-6963
Mailing Address - Fax:
Practice Address - Street 1:2190 N GRACE BLVD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-3416
Practice Address - Country:US
Practice Address - Phone:480-955-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ291939364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health