Provider Demographics
NPI:1568052892
Name:VAZQUEZ, NANCY L (LSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 DUFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1323
Mailing Address - Country:US
Mailing Address - Phone:412-418-3635
Mailing Address - Fax:
Practice Address - Street 1:500 MCKNIGHT PARK DR STE 502A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6517
Practice Address - Country:US
Practice Address - Phone:412-368-2205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137784104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker