Provider Demographics
NPI:1902551807
Name:GARCIA, TIARA J
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:J
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 1:126 LIBRARY LN
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3608
Mailing Address - Country:US
Mailing Address - Phone:914-670-1155
Mailing Address - Fax:
Practice Address - Street 1:2831 EXTERIOR ST APT 9L
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7116
Practice Address - Country:US
Practice Address - Phone:917-736-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician