Provider Demographics
NPI:1154439222
Name:VASQUEZ, JENNIFER GAYLE (OT CHT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GAYLE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:OT CHT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1441 WOODSTEAD CT
Mailing Address - Street 2:STE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1410
Mailing Address - Country:US
Mailing Address - Phone:281-364-7752
Mailing Address - Fax:281-292-2726
Practice Address - Street 1:1441 WOODSTEAD CT
Practice Address - Street 2:STE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1410
Practice Address - Country:US
Practice Address - Phone:281-364-7752
Practice Address - Fax:281-292-2726
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX108921225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T3022OtherBCBS OF TX
TX8T3022OtherBCBS OF TX