Provider Demographics
NPI:1285904466
Name:GARCIA, ROSIE V
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:V
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 APACHE WING ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6060
Mailing Address - Country:US
Mailing Address - Phone:702-396-4181
Mailing Address - Fax:
Practice Address - Street 1:4052 APACHE WING ST
Practice Address - Street 2:
Practice Address - City:LAS VEGASS
Practice Address - State:NV
Practice Address - Zip Code:89129-6060
Practice Address - Country:US
Practice Address - Phone:702-396-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst