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NPI Code Detail

MEDICARE: EVELYN MICHELLE GARICA-MARTINEZ

MEDICARE: EVELYN MICHELLE GARICA-MARTINEZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1972076941
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN MICHELLE GARICA-MARTINEZ
Provider Business Mailing Address
First Line : 7061 W ARBY AVE STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4464
Country : US
Telephone Number : 702-813-3437
Fax Number :
Provider Business Practice Location Address
First Line : 7061 W ARBY AVE STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4464
Country : US
Telephone Number : 702-813-3437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2019
Last Update Date : 04/14/2023

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Directions to “ EVELYN MICHELLE GARICA-MARTINEZ ” Practice Location

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