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General NPI Number Information
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NPI Number | 1114168432
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Entity Type | Individual
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Provider Name | RACHAEL SKULE VASQUEZ CMT
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Gender | Female
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 1 1/2 CROSSWICKS STREET
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City | BORDENTOWN
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State | NJ
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Zip | 08505
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Country | US
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Telephone | 609-298-4299
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Fax |
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Provider Business Mailing Address
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Address Line | 517 MAPLE AVE
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City | EWING
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State | NJ
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Zip | 08618-2660
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Country | US
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Telephone | 609-577-6333
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Fax | 609-406-0834
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 26BT00165600
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License Number State | NJ
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