Provider Demographics
NPI:1952170243
Name:GARCIA, GABRIELA (CSW-INTERN)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CHANDLER AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4064
Mailing Address - Country:US
Mailing Address - Phone:725-204-8809
Mailing Address - Fax:
Practice Address - Street 1:2500 CHANDLER AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4064
Practice Address - Country:US
Practice Address - Phone:725-204-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7093-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical