Provider Demographics
NPI:1407374135
Name:VAZQUEZ TORRES, LIZMARIE (MSW)
Entity Type:Individual
Prefix:
First Name:LIZMARIE
Middle Name:
Last Name:VAZQUEZ TORRES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624-13 CALLE GUARAGUAO
Mailing Address - Street 2:ALTURAS DE OLIMPO
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-941-8449
Mailing Address - Fax:
Practice Address - Street 1:STREET CECILIA DOMINGUEZ #11 ESTE
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:939-417-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR139171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical