Provider Demographics
NPI:1073370466
Name:GARCIA, INGRID (RBT-20-122597)
Entity Type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RBT-20-122597
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 SE 21ST LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5275
Mailing Address - Country:US
Mailing Address - Phone:305-560-4060
Mailing Address - Fax:
Practice Address - Street 1:11276 SW 232ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7505
Practice Address - Country:US
Practice Address - Phone:305-912-8399
Practice Address - Fax:305-508-6537
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician