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General NPI Number Information
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NPI Number | 1801922091
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Entity Type | Individual
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Provider Name | ANN M. VASQUEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 158 N MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4063
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Country | US
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Telephone | 219-663-0888
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Fax | 219-663-0887
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Provider Business Mailing Address
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Address Line | 158 N MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4063
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Country | US
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Telephone | 219-663-0888
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Fax | 219-663-0087
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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 | 34006863A
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License Number State | IN
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