Individual
ELLISE VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
141 E MAIN ST, 3RD FLOOR HOME BASED SERVICES, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 206-7937
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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