Provider Demographics
NPI:1164781902
Name:VAZQUEZ-SANCHEZ, MELISSA (BS)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:
Last Name:VAZQUEZ-SANCHEZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TREDEAU ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-3051
Mailing Address - Country:US
Mailing Address - Phone:860-713-8820
Mailing Address - Fax:
Practice Address - Street 1:45 WADSWORTH ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-7108
Practice Address - Country:US
Practice Address - Phone:860-527-1124
Practice Address - Fax:860-724-2539
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional