Individual
IAN VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 CARROLL RD, PARAGOULD, AR 72450-6333
(870) 897-2372
Mailing address
1005 OAKLAND DR, PARAGOULD, AR 72450-4870
(870) 212-1178
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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