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General NPI Number Information
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NPI Number | 1073121364
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Entity Type | Individual
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Provider Name | SERENA GARCIA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 2000 W 21ST ST APT 1
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City | CLOVIS
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State | NM
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Zip | 88101-4087
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Country | US
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Telephone | 575-288-1881
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5326
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Country | US
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Telephone | 248-299-0030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-72466
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License Number State | NM
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