Provider Demographics
NPI:1295424596
Name:GARCIA, TERESA MARIE
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111A POE ACRES RD
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-8125
Mailing Address - Country:US
Mailing Address - Phone:812-821-6272
Mailing Address - Fax:
Practice Address - Street 1:111A POE ACRES RD
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-8125
Practice Address - Country:US
Practice Address - Phone:812-821-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist