Individual
CASSANDRA LYNN VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 W BROAD ST, FORNEY, TX 75126-9148
(469) 458-9021
Mailing address
911 N GOLIAD ST, ROCKWALL, TX 75087-2230
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-149136
TX
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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