Provider Demographics
NPI:1659914307
Name:VAQUERA, DANIELA RAQUEL
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:RAQUEL
Last Name:VAQUERA
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 1:15809 W MEADE LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9785
Mailing Address - Country:US
Mailing Address - Phone:623-606-0556
Mailing Address - Fax:
Practice Address - Street 1:4870 N LITCHFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-5041
Practice Address - Country:US
Practice Address - Phone:623-935-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant