Individual
COURTNEY VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, LMT
Contact information
Practice address
712 CAULDWELL AVE, BRONX, NY 10455-1531
(718) 844-1719
Mailing address
712 CAULDWELL AVE, BRONX, NY 10455-1531
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005944-1
NY
225700000X
Massage Therapist
027581-1
NY
Other
Enumeration date
10/07/2017
Last updated
10/07/2017
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