Individual
JESSICA VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8241 PIONEER DR, ANCHORAGE, AK 99504-4712
(907) 929-5826
Mailing address
7521 BRAYTON DR, ANCHORAGE, AK 99507-2667
(907) 929-5826
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N.A
N.A
AK
Enumeration date
08/20/2020
Last updated
06/28/2023
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