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NPI Code Detail

MEDICARE: AYLA CODA GARCIA MS, QMHP-A, QDDP

MEDICARE: AYLA CODA GARCIA MS, QMHP-A, QDDP
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
1101YM0800XMental Health Counselor0732007540VA

General Provider Information

NPI Number : 1881374148
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYLA CODA GARCIA MS, QMHP-A, QDDP
Provider Business Mailing Address
First Line : 2807 N PARHAM RD STE 260
Second Line :
City : HENRICO
State : VA
Zip : 23294-4414
Country : US
Telephone Number : 804-315-3177
Fax Number : 804-315-0202
Provider Business Practice Location Address
First Line : 2807 N PARHAM RD STE 260
Second Line :
City : HENRICO
State : VA
Zip : 23294-4414
Country : US
Telephone Number : 804-315-3177
Fax Number : 804-315-0202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2023
Last Update Date : 07/21/2023

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