Provider Demographics
NPI:1235952573
Name:GARCES ALIAGA, GLENIS GICELLE
Entity type:Individual
Prefix:
First Name:GLENIS
Middle Name:GICELLE
Last Name:GARCES ALIAGA
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 1:9375 SW 40TH TER APT 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5254
Mailing Address - Country:US
Mailing Address - Phone:786-526-7776
Mailing Address - Fax:
Practice Address - Street 1:9375 SW 40TH TER APT 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5254
Practice Address - Country:US
Practice Address - Phone:786-526-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-295995106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician