Healthcare Provider Details

I. General information

NPI: 1518012830
Provider Name (Legal Business Name): OLGA B. VASQUEZ DBA ONE FOR AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12003 HUEBNER RD
SAN ANTONIO TX
78230-1203
US

IV. Provider business mailing address

12003 HUEBNER RD
SAN ANTONIO TX
78230-1203
US

V. Phone/Fax

Practice location:
  • Phone: 210-680-8737
  • Fax: 210-696-6600
Mailing address:
  • Phone: 210-680-8737
  • Fax: 210-696-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLGA BERENICE VASQUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A.
Phone: 210-680-8737