Provider Demographics
NPI:1710223706
Name:GARCIA, EILEEN OHARA (MSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:OHARA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 W SANTIAGO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-6930
Mailing Address - Country:US
Mailing Address - Phone:813-220-3920
Mailing Address - Fax:
Practice Address - Street 1:3825 HENDERSON BLVD
Practice Address - Street 2:SUITE304
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5037
Practice Address - Country:US
Practice Address - Phone:813-220-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW77611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical