Provider Demographics
NPI:1285455121
Name:VASQUEZ, SABRINA MARIE (LCDC)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11843 BRAESVIEW APT 1305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4829
Mailing Address - Country:US
Mailing Address - Phone:210-891-9002
Mailing Address - Fax:
Practice Address - Street 1:3701 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3611
Practice Address - Country:US
Practice Address - Phone:210-434-0531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)