Provider Demographics
NPI:1629225644
Name:GARCIA, LYDIA ESTHER (PSYD)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:ESTHER
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 1:7 AVE LAGUNA
Mailing Address - Street 2:CONDOMINIO LAGOMAR APT. 5-C
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6501
Mailing Address - Country:US
Mailing Address - Phone:787-914-3122
Mailing Address - Fax:787-791-2661
Practice Address - Street 1:829 AVE SAN PATRICIO
Practice Address - Street 2:CENTRO COMERCIAL UMBO SEGUNDO NIVEL
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921-1314
Practice Address - Country:US
Practice Address - Phone:787-783-0503
Practice Address - Fax:787-791-2661
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2976103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical