Provider Demographics
NPI:1982443925
Name:CONCEPCION GARCIA, KLEDIA DAYANA
Entity type:Individual
Prefix:
First Name:KLEDIA
Middle Name:DAYANA
Last Name:CONCEPCION 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 1:1650 W 44TH PL APT 119
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7472
Mailing Address - Country:US
Mailing Address - Phone:786-709-5567
Mailing Address - Fax:
Practice Address - Street 1:1650 W 44TH PL APT 119
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7472
Practice Address - Country:US
Practice Address - Phone:786-709-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician