=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497545271
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE GARCIA SCHOOL PSYCHOLOGIST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2025
-----------------------------------------------------
Last Update Date | 05/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 NW 11TH ST
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47501-9781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-254-8366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 637
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47501-0637
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-254-1530
-----------------------------------------------------
Fax | 812-254-1636
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 10326063
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------