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General NPI Number Information
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NPI Number | 1336235753
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Entity Type | Individual
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Provider Name | JOSE RAFAEL VAZQUEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 700 19TH ST S 116 MHC/PCT
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1927
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Country | US
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Telephone | 205-933-8101
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Fax | 205-939-4576
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Provider Business Mailing Address
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Address Line | 3451 KILDARE DR N/A
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City | HOOVER
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State | AL
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Zip | 35226-2119
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Country | US
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Telephone | 205-979-3711
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Fax | 205-939-4576
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S10080
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License Number State | TX
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