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Individual

ISAAC A VAZQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMHC, LMFT

Contact information

Practice address
379 N UNIVERSITY AVE STE 300, PROVO, UT 84601-2878
(801) 341-9521
Mailing address
4076 E SOUTH PASS RD, EAGLE MOUNTAIN, UT 84005-6049
(801) 341-9521

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11009876-6004
UT
106H00000X
Marriage & Family Therapist
11009876-3902
UT

Other

Enumeration date
07/30/2013
Last updated
03/09/2024
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