Provider Demographics
NPI:1598214215
Name:MARRERO-VAZQUEZ, ARACELIS
Entity Type:Individual
Prefix:
First Name:ARACELIS
Middle Name:
Last Name:MARRERO-VAZQUEZ
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 1:2425 SAINT GEORGE ST
Mailing Address - Street 2:8
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5483
Mailing Address - Country:US
Mailing Address - Phone:702-488-3413
Mailing Address - Fax:
Practice Address - Street 1:2425 SAINT GEORGE ST
Practice Address - Street 2:8
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5483
Practice Address - Country:US
Practice Address - Phone:702-488-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst