Provider Demographics
NPI:1952654469
Name:VAZQUEZ, GERALDINE FRANCHESKA (MA ED)
Entity Type:Individual
Prefix:MISS
First Name:GERALDINE
Middle Name:FRANCHESKA
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-0174
Mailing Address - Country:US
Mailing Address - Phone:787-397-1817
Mailing Address - Fax:
Practice Address - Street 1:70 COLOMBIA
Practice Address - Street 2:CENTRO DEL OESTE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-397-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4350103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool