Provider Demographics
NPI:1265444285
Name:GARCIA, JOAQUIN (REV)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:REV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 SUMMERWIND CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6125
Mailing Address - Country:US
Mailing Address - Phone:615-665-9875
Mailing Address - Fax:615-665-9875
Practice Address - Street 1:612 SUMMERWIND CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6125
Practice Address - Country:US
Practice Address - Phone:615-665-9875
Practice Address - Fax:615-665-9875
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral