Provider Demographics
NPI:1518121201
Name:GARCIA, JUDY LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:LYNN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4799 CALLE DE NUBES
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-9570
Mailing Address - Country:US
Mailing Address - Phone:505-263-3993
Mailing Address - Fax:
Practice Address - Street 1:1400 N SILVER ST
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1957
Practice Address - Country:US
Practice Address - Phone:575-743-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1005225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist