Provider Demographics
NPI:1235663956
Name:GARCIA, MARIBEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 70 BOX 30824
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-9709
Mailing Address - Country:US
Mailing Address - Phone:787-240-3486
Mailing Address - Fax:
Practice Address - Street 1:53 CALLE EUGENIO SANCHEZ LOPEZ
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-9709
Practice Address - Country:US
Practice Address - Phone:787-240-3486
Practice Address - Fax:787-363-1501
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2852103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling