Provider Demographics
NPI:1932089968
Name:GARCIA, JADELYN MARIEL
Entity type:Individual
Prefix:
First Name:JADELYN
Middle Name:MARIEL
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 1:1321 CHERRY HOLLOW WAY APT 207
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-5941
Mailing Address - Country:US
Mailing Address - Phone:917-893-1680
Mailing Address - Fax:
Practice Address - Street 1:3618 RIVER WATCH LN
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-7051
Practice Address - Country:US
Practice Address - Phone:919-213-0320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician