Individual
ANGELICA VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4143 GARDENDALE ST, SAN ANTONIO, TX 78229-3129
(210) 319-9807
Mailing address
427 BRIDGIT DR, CONVERSE, TX 78109-1501
(210) 739-9740
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1091554
TX
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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