Provider Demographics
NPI:1891031167
Name:GARCIA, EPIFANIO JR (CMHC-I)
Entity type:Individual
Prefix:MR
First Name:EPIFANIO
Middle Name:JR
Last Name:GARCIA
Suffix:
Gender:M
Credentials:CMHC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 S REDWOOD RD
Mailing Address - Street 2:BLDG. E
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4007
Mailing Address - Country:US
Mailing Address - Phone:801-946-7330
Mailing Address - Fax:
Practice Address - Street 1:7601 S REDWOOD RD
Practice Address - Street 2:BLDG. E
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4007
Practice Address - Country:US
Practice Address - Phone:801-946-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional