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Individual

ROWAN M VASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Mailing address
PO BOX 988, KENAI, AK 99611-0988

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
172V00000X
Community Health Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1719637
AK
Enumeration date
03/23/2021
Last updated
10/13/2025
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