Individual
MRS. LIDUVINA VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
17 W MERRICK RD, FREEPORT, NY 11520-3873
(516) 868-3030
(516) 868-3374
Mailing address
17 W MERRICK RD, FREEPORT, NY 11520-3873
(516) 868-3030
(516) 868-3374
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K00000X
NY
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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