Provider Demographics
NPI:1629785571
Name:VAZQUEZ, REBECCA (LPC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 US HIGHWAY 1 # 104
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4402
Mailing Address - Country:US
Mailing Address - Phone:732-867-8777
Mailing Address - Fax:
Practice Address - Street 1:3 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-8552
Practice Address - Country:US
Practice Address - Phone:856-305-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00691500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional