Healthcare Provider Details

I. General information

NPI: 1841587201
Provider Name (Legal Business Name): DIANA NICOLE GARCIA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 BLANCO RD SUITE 501
SAN ANTONIO TX
78216-4936
US

IV. Provider business mailing address

PO BOX 460429
SAN ANTONIO TX
78246-0429
US

V. Phone/Fax

Practice location:
  • Phone: 210-446-8255
  • Fax: 888-823-3497
Mailing address:
  • Phone: 210-446-8255
  • Fax: 888-823-3497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number65945
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number65945
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: