Provider Demographics
NPI:1144987579
Name:GARCIA, KIARA M (LCDA)
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. LAGUNA GARDENS 1 AVE. LAGUNA
Mailing Address - Street 2:APT 3H
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-781-7971
Mailing Address - Fax:
Practice Address - Street 1:AVE. LAGUNA COND LAGUNA GARDENS 1
Practice Address - Street 2:APT 3H
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-354-3903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6360103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty