Individual
MATTHEW EDWARD VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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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