Provider Demographics
NPI:1578249371
Name:VASQUEZ SALDARRIAGA, JENNIFER (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:VASQUEZ SALDARRIAGA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 WOODRUFF RD STE 2100 #335
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29369-0001
Mailing Address - Country:US
Mailing Address - Phone:864-514-4309
Mailing Address - Fax:
Practice Address - Street 1:109 SAINT CHARLES COURT
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:SC
Practice Address - Zip Code:29369
Practice Address - Country:US
Practice Address - Phone:864-514-4309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7024106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist