Individual
JEANETTE P VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2180 E 4500 S, UNIT #105, HOLLADAY, UT 84117-4434
(801) 680-4728
(801) 748-2554
Mailing address
5451 S 1410 E, SALT LAKE CITY, UT 84117-7359
(801) 680-4728
(801) 748-2554
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3444653501
UT
Other
Enumeration date
11/30/2007
Last updated
07/27/2012
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