Individual
AMANDA ALEXIS VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1383 CIMARRON CIR, FAIRBORN, OH 45324-6207
(937) 802-6815
Mailing address
1383 CIMARRON CIR, FAIRBORN, OH 45324-6207
(937) 802-6815
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
04/22/2025
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