Individual
LAUREN CATHERINE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 MARKET ST FL 3, PHILADELPHIA, PA 19139-4636
(215) 590-7555
Mailing address
4601 MARKET ST FL 3, PHILADELPHIA, PA 19139-4636
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS019961
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/07/2023
Last updated
08/21/2023
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