Provider Demographics
NPI:1992420988
Name:RIOS GARCIA, YESICA (RBT)
Entity type:Individual
Prefix:
First Name:YESICA
Middle Name:
Last Name:RIOS GARCIA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14986 CHEYENNE WAY
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-2925
Mailing Address - Country:US
Mailing Address - Phone:703-223-6925
Mailing Address - Fax:
Practice Address - Street 1:14986 CHEYENNE WAY
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2925
Practice Address - Country:US
Practice Address - Phone:703-223-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty