Healthcare Provider Details

I. General information

NPI: 1720728330
Provider Name (Legal Business Name): MARIA I GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SPRUCE ST
LEOMINSTER MA
01453-3361
US

IV. Provider business mailing address

90 MADISON ST STE 402
WORCESTER MA
01608-2073
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-6116
  • Fax:
Mailing address:
  • Phone: 857-200-7587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: