Basic Information
| Provider Information | |||||||||
| NPI: | 1457771396 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | FELICIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1002 W. HONDO AVE. | ||||||||
| Address2: | |||||||||
| City: | DEVINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8306639786 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1002 W. HONDO AVE. | ||||||||
| Address2: | |||||||||
| City: | DEVINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8306639786 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2014 | ||||||||
| LastUpdateDate: | 04/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 71595 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.