Provider Demographics
NPI:1295058162
Name:GARCIA-LAVIN, MARTA (NBCT, MS)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:GARCIA-LAVIN
Suffix:
Gender:F
Credentials:NBCT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PARKVIEW DR APT 101
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2923
Mailing Address - Country:US
Mailing Address - Phone:305-439-5003
Mailing Address - Fax:
Practice Address - Street 1:800 PARKVIEW DR APT 101
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2923
Practice Address - Country:US
Practice Address - Phone:305-439-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL614373252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency