Provider Demographics
NPI:1336641166
Name:GARCIA, NICOLE RAQUEL (BA)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:RAQUEL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:515 S SUGAR RD APT 237
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5478
Mailing Address - Country:US
Mailing Address - Phone:956-638-6597
Mailing Address - Fax:956-287-4052
Practice Address - Street 1:1132 N CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-2556
Practice Address - Country:US
Practice Address - Phone:956-240-4210
Practice Address - Fax:956-287-4052
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty