Healthcare Provider Details

I. General information

NPI: 1194645077
Provider Name (Legal Business Name): DIANA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43B BIRCH ST STE 3C
DERRY NH
03038-2718
US

IV. Provider business mailing address

48 MONTGOMERY ST APT 1
LAWRENCE MA
01841-1263
US

V. Phone/Fax

Practice location:
  • Phone: 978-238-0698
  • Fax:
Mailing address:
  • Phone: 978-238-0698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18752
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9287
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: