Individual
ASHLIE DANIELLE VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
875 MERCANTIL AVE, ANTHONY, NM 88021
(575) 874-3592
Mailing address
PO DRAWER70, MEDICAID DEPT, ANTHONY, NM 88021
(575) 882-6101
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114377
TX
235Z00000X
Speech-Language Pathologist
C-6123
NM
Other
Enumeration date
02/13/2017
Last updated
06/18/2018
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