Organization
CUMBERLAND FAMILY BEHAVIORAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL F. VASQUEZ MD (OWNER)
(606) 878-1961
Entity
Organization
Contact information
Practice address
1675 S MAIN ST, LONDON, KY 40741-2050
(606) 878-1961
(606) 877-1958
Mailing address
1675 S MAIN ST, LONDON, KY 40741-2050
(606) 878-1961
(606) 877-1958
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35016
KY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35016
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3220P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943177
—
KY
Enumeration date
08/09/2006
Last updated
01/05/2010
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