Provider Demographics
NPI:1881374148
Name:GARCIA, AYLA CODA (MS, QMHP-A, QDDP)
Entity type:Individual
Prefix:
First Name:AYLA
Middle Name:CODA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, QMHP-A, QDDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 N PARHAM RD STE 260
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4414
Mailing Address - Country:US
Mailing Address - Phone:804-315-3177
Mailing Address - Fax:804-315-0202
Practice Address - Street 1:2807 N PARHAM RD STE 260
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4414
Practice Address - Country:US
Practice Address - Phone:804-315-3177
Practice Address - Fax:804-315-0202
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0732007540101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health