Provider Demographics
NPI:1750847695
Name:VASQUEZ, CHRISTINA AMELIA (MED , LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:AMELIA
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:MED , LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 S TEXAS BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6191
Mailing Address - Country:US
Mailing Address - Phone:956-532-5506
Mailing Address - Fax:
Practice Address - Street 1:110 E AGOSTADERO ST STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5320
Practice Address - Country:US
Practice Address - Phone:956-532-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional