Individual
MATTHEW EDWARD VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
502 W 29TH ST, TUCSON, AZ 85713-3353
(520) 838-3818
Mailing address
3935 N COUNTRY CLUB RD APT 36A, TUCSON, AZ 85716-6004
(520) 884-0554
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC - 10966
AZ
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC-12939
AZ
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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