MEDICARE: CELINA MARIE GARCIA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	105486	TX

General Provider Information

NPI Number	:	1952828337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINA MARIE GARCIA CCC-SLP

Provider Business Mailing Address
First Line	:	3520 EXECUTIVE CENTER DR STE 128
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-1636
Country	:	US
Telephone Number	:	512-343-0222
Fax Number	:	512-343-0223

Provider Business Practice Location Address
First Line	:	3520 EXECUTIVE CENTER DR STE 128
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-1636
Country	:	US
Telephone Number	:	512-343-0222
Fax Number	:	512-343-0223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	07/21/2022

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Directions to “ CELINA MARIE GARCIA CCC-SLP” Practice Location

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