MEDICARE: MS. JANET LYNN HARRISON-GARCIA LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I-3417	NM

General Provider Information

NPI Number	:	1205004827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET LYNN HARRISON-GARCIA LISW

Provider Business Mailing Address
First Line	:	24 HERRADA RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-8204
Country	:	US
Telephone Number	:	505-466-6720
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 RODEO PARK DR W
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6353
Country	:	US
Telephone Number	:	505-986-9633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2008
Last Update Date	:	02/16/2008

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