Individual
MYA LEILANI VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68 W 106TH ST, NEW YORK, NY 10025-3855
(646) 790-7364
(646) 850-0385
Mailing address
68 W 106TH ST, NEW YORK, NY 10025-3855
(646) 790-7364
(646) 850-0385
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36721
NY
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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