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Individual

MR. IGNACIO VASQUEZ AYALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
3428 E DOUGLAS AVE # 1, STUITE 102, WICHITA, KS 67208-3325
(316) 204-7759
(316) 337-5249
Mailing address
3428 E DOUGLAS AVE # 1, WICHITA, KS 67208-3325
(316) 204-7759
(316) 337-5249

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7968
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2008775060A
KS
Enumeration date
10/07/2011
Last updated
01/04/2017
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