Provider Demographics
NPI:1902582117
Name:CHAPARRO, LETICIA GARCIA (APC)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:GARCIA
Last Name:CHAPARRO
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4682 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8515
Mailing Address - Country:US
Mailing Address - Phone:912-312-5054
Mailing Address - Fax:
Practice Address - Street 1:4682 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-8515
Practice Address - Country:US
Practice Address - Phone:912-312-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC007998101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor