Doctor Name: | LACEY LYNN VASQUEZ |
NPI Number: | 1033529326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | 19073 |
Business Practice Address: | 661 W 1st St Suite E. Tustin, CA - 927802939 |
Business Phone Number: | 7148382853 |
Business Fax Number: | 7148384533 |
Mailing Address: | 661 W 1st St, Suite E. TUSTIN |
State: | CA |
Postal Code: | 927802939 |
Phone Number: | 7148382853 |
Fax Number: | 7148384533 |
NPI Enumeration Date: | 05/07/2014 |
NPI Last Update Date: | 05/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 19073 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |