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General NPI Number Information
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NPI Number | 1477842649
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Entity Type | Individual
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Provider Name | ANJANETTE VAZQUEZ M.A
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Gender | Female
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | J5 CALLE CHURCH HL TORRIMAR
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City | GUAYNABO
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State | PR
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Zip | 00966-3109
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Country | US
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Telephone | 787-645-1165
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 AVE ALEJANDRINO APT 1302 FONTAINEBLEU PLAZA
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City | GUAYNABO
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State | PR
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Zip | 00969-7041
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Country | US
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Telephone | 787-645-1165
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Fax | 787-793-8076
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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 | 1540
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License Number State | PR
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