Individual
JEREMY VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
29 LEHIGH AVE, PUEBLO, CO 81005-1961
(719) 549-7843
Mailing address
29 LEHIGH AVE, PUEBLO, CO 81005-1961
(719) 549-7843
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09929605
CO
1041S0200X
School Social Worker
24485746
CO
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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