Provider Demographics
NPI:1972399400
Name:VASQUEZ, ABIGAIL (LMSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4092 TPC PKWY APT 1031
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2934
Mailing Address - Country:US
Mailing Address - Phone:361-227-9238
Mailing Address - Fax:
Practice Address - Street 1:11901 TOEPPERWEIN RD STE 1202
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3159
Practice Address - Country:US
Practice Address - Phone:210-951-3479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115484104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty