Provider Demographics
NPI:1144947425
Name:GARCIA, BRITTNEY A (CPSW)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HAGEN RD
Mailing Address - Street 2:
Mailing Address - City:SAN FELIPE PUEBLO
Mailing Address - State:NM
Mailing Address - Zip Code:87001
Mailing Address - Country:US
Mailing Address - Phone:505-420-4590
Mailing Address - Fax:
Practice Address - Street 1:51 BOSQUE RD
Practice Address - Street 2:
Practice Address - City:ALGODONES
Practice Address - State:NM
Practice Address - Zip Code:87001-8014
Practice Address - Country:US
Practice Address - Phone:505-420-4590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1154175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist