Individual
DEBRA VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 RIDGEDALEROAD, SOUTH BEND, IN 46615
(574) 291-6722
Mailing address
PO BOX 81, NILES, MI 49120-0081
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000856A
IN
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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