MEDICARE: RACHEL VASQUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801089922	MI

General Provider Information

NPI Number	:	1063375491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL VASQUEZ

Provider Business Mailing Address
First Line	:	2513 HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-6358
Country	:	US
Telephone Number	:	734-545-1354
Fax Number	:

Provider Business Practice Location Address
First Line	:	2513 HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-6358
Country	:	US
Telephone Number	:	734-545-1354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ RACHEL VASQUEZ ” Practice Location

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