Healthcare Provider Details

I. General information

NPI: 1902417348
Provider Name (Legal Business Name): ELIZABETH KATHERINE GARCIA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 VIRGINIA AVE
WILMINGTON NC
28401-7000
US

IV. Provider business mailing address

101 VIRGINIA AVE
WILMINGTON NC
28401-7000
US

V. Phone/Fax

Practice location:
  • Phone: 919-375-0475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: