Provider Demographics
NPI:1417608027
Name:GARCIA, JASMINTH
Entity Type:Individual
Prefix:
First Name:JASMINTH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 SPEAR POINT TRL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2551
Mailing Address - Country:US
Mailing Address - Phone:678-392-7503
Mailing Address - Fax:
Practice Address - Street 1:2309 SPEAR POINT TRL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2551
Practice Address - Country:US
Practice Address - Phone:678-392-7503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician