Individual
JONATHAN VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4400 N 19TH ST APT 404, WACO, TX 76708-1162
(254) 981-6103
Mailing address
4400 N 19TH ST APT 404, WACO, TX 76708-1162
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/13/2021
Last updated
06/13/2021
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