Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 104469 | NY |
NPI | 1003390121 |
---|---|
Provider Name | Pamela Alejandra Garcia |
First Address | Jackson Heights, NY 11372-7935 |
Second Address | Jackson Heights, NY 11372-7935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2018 |
Last Update Date | 25/09/2018 |