Provider Demographics
NPI:1205389368
Name:GARCIA, MICHELE (CRT IN SPIRITUAL PSY)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CRT IN SPIRITUAL PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19375 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92241-1559
Mailing Address - Country:US
Mailing Address - Phone:310-968-0993
Mailing Address - Fax:
Practice Address - Street 1:19375 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92241-1559
Practice Address - Country:US
Practice Address - Phone:310-968-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional