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Individual

JENNIFER GARCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9911 SE MOUNT SCOTT BLVD, PORTLAND, OR 97266-6302
(503) 233-4356
Mailing address
1809 SE HAWTHORNE BLVD, APT. A, PORTLAND, OR 97214-3869
(707) 718-6932

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
09/30/2011
Last updated
09/30/2011
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