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General NPI Number Information
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NPI Number | 1558083808
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Entity Type | Individual
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Provider Name | JULIE VASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 1800 CRAIG-KLAWOCK HIGHWAY STE 241
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City | CRAIG
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State | AK
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Zip | 99925
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Country | US
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Telephone | 907-225-7825
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 544
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City | KLAWOCK
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State | AK
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Zip | 99925-0544
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Country | US
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Telephone | 907-401-0378
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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