Provider Demographics
NPI:1164673778
Name:VASQUEZ, LINDSAY NIEVECITAS
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:NIEVECITAS
Last Name:VASQUEZ
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 1:1359 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3257
Mailing Address - Country:US
Mailing Address - Phone:575-635-6222
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE STE 290
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3759
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health