Provider Demographics
NPI:1972207090
Name:GARCIA, CRISTINA M
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:M
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 1:1660 FORT ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2003
Mailing Address - Country:US
Mailing Address - Phone:347-304-4159
Mailing Address - Fax:734-304-4162
Practice Address - Street 1:1660 FORT STREET
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2984
Practice Address - Country:US
Practice Address - Phone:586-204-5560
Practice Address - Fax:734-304-4162
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty