Healthcare Provider Details

I. General information

NPI: 1770763435
Provider Name (Legal Business Name): TERESITA Q GARCIA L.M.H.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2007
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date: 03/07/2016
Reactivation Date: 07/31/2020

III. Provider practice location address

8600 NW 178TH ST
HIALEAH FL
33015
US

IV. Provider business mailing address

8600 NW 178TH ST
HIALEAH FL
33015-3535
US

V. Phone/Fax

Practice location:
  • Phone: 305-282-4947
  • Fax:
Mailing address:
  • Phone: 305-282-4947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9196
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: