| Doctor Name: | SHELLEY VASQUEZ |
| NPI Number: | 1609948181 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 701001818 |
| Business Practice Address: | 1 W Williamsburg Rd Sandston, VA - 231502009 |
| Business Phone Number: | 8049082532 |
| Business Fax Number: | 8043431613 |
| Mailing Address: | 1 W Williamsburg Rd, SANDSTON |
| State: | VA |
| Postal Code: | 231502009 |
| Phone Number: | 8048641320 |
| Fax Number: | 8048641323 |
| NPI Enumeration Date: | 11/14/2006 |
| NPI Last Update Date: | 11/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 701001818 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |