Provider Demographics
NPI:1174022636
Name:GARCIA HERNANDEZ, INDIRA (RBT)
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:
Last Name:GARCIA HERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 SW 38TH CT APT 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7358
Mailing Address - Country:US
Mailing Address - Phone:786-209-4978
Mailing Address - Fax:
Practice Address - Street 1:2970 SW 38TH CT APT 5
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134-7358
Practice Address - Country:US
Practice Address - Phone:786-209-4978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty