Individual
CHRISTINE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A, ATR-BC
Contact information
Practice address
508 BETHEL ST, CLOVER, SC 29710-1154
(803) 675-8227
Mailing address
16047 PAGO PAGO DR, TEGA CAY, SC 29708-8538
(516) 965-4175
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6876
SC
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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