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NPI Code Detail

MEDICARE: LETICIA MARIA VAZQUEZ

MEDICARE:   LETICIA MARIA VAZQUEZ
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
1106S00000XBehavior TechnicianRBT-23-308933NC

General Provider Information

NPI Number : 1922872977
Entity Type Code : Individual
Provider Name (Legal Business Name) : LETICIA MARIA VAZQUEZ
Provider Business Mailing Address
First Line : 8695 BEND OF THE RIVER RD
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27803-8886
Country : US
Telephone Number : 252-903-9955
Fax Number :
Provider Business Practice Location Address
First Line : 115 W NASHVILLE DR
Second Line :
City : NASHVILLE
State : NC
Zip : 27856-1284
Country : US
Telephone Number : 919-375-0475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2023
Last Update Date : 11/09/2023

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Directions to “ LETICIA MARIA VAZQUEZ ” Practice Location

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