Provider Demographics
NPI:1629183025
Name:VAZQUEZ, ROSALIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSALIA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12830 CHASELAND LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3723
Mailing Address - Country:US
Mailing Address - Phone:713-201-1321
Mailing Address - Fax:346-635-0045
Practice Address - Street 1:12830 CHASELAND LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3723
Practice Address - Country:US
Practice Address - Phone:713-201-1321
Practice Address - Fax:346-635-0045
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1790101YA0400X
TX216371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)