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General NPI Number Information
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NPI Number | 1184972895
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE VASQUEZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 1335 N CHERRY AVE
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City | TUCSON
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State | AZ
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Zip | 85721-1134
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Country | US
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Telephone | 520-626-2982
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Fax | 520-626-2525
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Provider Business Mailing Address
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Address Line | 1335 N CHERRY AVE PO BOX 210572
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City | TUCSON
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State | AZ
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Zip | 85721-1134
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Country | US
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Telephone | 520-626-2982
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Fax | 520-626-2525
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4306
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License Number State | AZ
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