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Individual

CARMEN VAZQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3720 W 82ND PL, CHICAGO, IL 60652-2408
(773) 707-8345
Mailing address
3720 W 82ND PL, CHICAGO, IL 60652-2408

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
V22610592716
IL

Other

Enumeration date
11/09/2018
Last updated
11/09/2018
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