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General NPI Number Information
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NPI Number | 1558079137
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Entity Type | Individual
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Provider Name | VIVIAN VANESSA GARCIA LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 8045 BIG BEND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-2709
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Country | US
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Telephone | 314-800-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 7253 WATSON RD # 169
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City | SAINT LOUIS
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State | MO
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Zip | 63119-4401
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2022040046
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License Number State | MO
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