Provider Demographics
NPI:1639842966
Name:GARCIA, JENNIFER L (RBT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 PARKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-3265
Mailing Address - Country:US
Mailing Address - Phone:903-312-1315
Mailing Address - Fax:
Practice Address - Street 1:900 HWY 6
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:903-312-1315
Practice Address - Fax:866-790-8027
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT21174452106S00000X
TX1-24-70975103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRBT21174452OtherBACB
TX1-24-70975OtherBACB