Provider Demographics
NPI:1144805631
Name:VAZQUEZ, RHANADA
Entity Type:Individual
Prefix:DR
First Name:RHANADA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 INDIAN RIVER RD STE E
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3042
Mailing Address - Country:US
Mailing Address - Phone:757-336-8356
Mailing Address - Fax:757-257-3450
Practice Address - Street 1:4214 INDIAN RIVER RD STE E
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3042
Practice Address - Country:US
Practice Address - Phone:757-336-8356
Practice Address - Fax:757-257-3450
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health