Individual
JACKELINE NOEMI VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3153 REYNOLDA RD, WINSTON SALEM, NC 27106-3009
(336) 293-4463
Mailing address
3153 REYNOLDA RD, WINSTON SALEM, NC 27106-3009
(336) 293-4463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13609
NC
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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