Individual
STEPHANIE GLORIA VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, ATC, LAT
Contact information
Practice address
1496 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-5018
(678) 902-2821
Mailing address
1496 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-5018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001689
GA
Other
Enumeration date
10/04/2009
Last updated
05/22/2016
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