Provider Demographics
NPI:1053803262
Name:GARCIA, KAMA DIANTHA (MSC, NCC, LAC)
Entity type:Individual
Prefix:MRS
First Name:KAMA
Middle Name:DIANTHA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSC, NCC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W ORANGE GROVE RD STE 604
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1141
Mailing Address - Country:US
Mailing Address - Phone:520-229-6220
Mailing Address - Fax:520-522-3033
Practice Address - Street 1:2001 W. ORANGE GROVE RD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-229-6220
Practice Address - Fax:520-544-3033
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health