Provider Demographics
NPI:1023841301
Name:GARCIA, VICKY DIMARY
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:DIMARY
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 1:69 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2253
Mailing Address - Country:US
Mailing Address - Phone:978-601-7932
Mailing Address - Fax:
Practice Address - Street 1:439 S UNION ST STE 104
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2844
Practice Address - Country:US
Practice Address - Phone:978-648-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health