Provider Demographics
NPI:1497578298
Name:GARCIA HERNANDEZ, MIREYA VIVIAN (RBT)
Entity type:Individual
Prefix:MS
First Name:MIREYA
Middle Name:VIVIAN
Last Name:GARCIA HERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 W 79TH PL APT 305
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4355
Mailing Address - Country:US
Mailing Address - Phone:786-470-6858
Mailing Address - Fax:
Practice Address - Street 1:291 W 79TH PL APT 305
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4355
Practice Address - Country:US
Practice Address - Phone:786-470-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician