MEDICARE: CLARA GARCIA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1679291652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARA GARCIA

Provider Business Mailing Address
First Line	:	2723 19TH ST
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-2319
Country	:	US
Telephone Number	:	620-797-8675
Fax Number	:

Provider Business Practice Location Address
First Line	:	2723 19TH ST
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-2319
Country	:	US
Telephone Number	:	620-797-8675
Fax Number	:

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

Provider Enumeration Date	:	08/16/2022
Last Update Date	:	08/16/2022

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Directions to “ CLARA GARCIA ” Practice Location

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