Individual
MS. STACY M VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2120 RAMROD AVE, 1212, HENDERSON, NV 89014-2008
(702) 860-4549
Mailing address
2120 RAMROD AVE, 1212, HENDERSON, NV 89014-2008
(702) 860-4549
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2789-S
NV
1041C0700X
Clinical Social Worker
Primary
5763-C
NV
1041C0700X
Clinical Social Worker
IC-520
NV
Other
Enumeration date
07/28/2006
Last updated
03/17/2015
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