Provider Demographics
NPI:1760752745
Name:GARCIA, MARIA (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 WILLARD RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-1028
Mailing Address - Country:US
Mailing Address - Phone:203-903-3145
Mailing Address - Fax:
Practice Address - Street 1:1054 WILLARD RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-1028
Practice Address - Country:US
Practice Address - Phone:203-903-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000933106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist