Provider Demographics
NPI:1891512448
Name:VAZQUEZ, ELIZABETH SUZANNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUZANNE
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 N WALLING LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7317
Mailing Address - Country:US
Mailing Address - Phone:831-756-3908
Mailing Address - Fax:
Practice Address - Street 1:2440 W SHAW AVE STE 209
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3300
Practice Address - Country:US
Practice Address - Phone:559-797-1873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist