| Doctor Name: | DALMA VAZQUEZ-WACKT |
| NPI Number: | 1104275783 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 178.010683 |
| Business Practice Address: | 115 N 1st St Dekalb, IL - 601153201 |
| Business Phone Number: | 8157519694 |
| Business Fax Number: | |
| Mailing Address: | 1215 Highpointe Dr, DEKALB |
| State: | IL |
| Postal Code: | 601156102 |
| Phone Number: | 8159015067 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2016 |
| NPI Last Update Date: | 06/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178.010683 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |