Provider Demographics
NPI:1881994929
Name:GARCIA, YOLANDA
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
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 1:3023 CALLE CARAMBOLA
Mailing Address - Street 2:LOS CAOBOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2739
Mailing Address - Country:US
Mailing Address - Phone:787-843-4232
Mailing Address - Fax:787-844-4130
Practice Address - Street 1:3023 CALLE CARAMBOLA
Practice Address - Street 2:LOS CAOBOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2739
Practice Address - Country:US
Practice Address - Phone:787-843-4232
Practice Address - Fax:787-844-4130
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRACIII15622739101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)