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Individual

IMELDA VASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPS

Contact information

Practice address
6363 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 399-4838
(210) 877-9279
Mailing address
6363 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 399-4838
(210) 877-9279

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
74344
TX

Other

Enumeration date
10/06/2017
Last updated
10/06/2017
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