Provider Demographics
NPI:1932445376
Name:GALICIA, MARCELA AGUILAR
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:AGUILAR
Last Name:GALICIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCELA
Other - Middle Name:PAOLA
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1655 PALM BEACH LAKES BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2203
Mailing Address - Country:US
Mailing Address - Phone:561-612-6000
Mailing Address - Fax:561-612-6098
Practice Address - Street 1:1655 PALM BEACH LAKES BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2203
Practice Address - Country:US
Practice Address - Phone:561-612-6000
Practice Address - Fax:561-612-6098
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11745103T00000X
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist