Provider Demographics
NPI:1982179792
Name:MEZA, VANESSA R
Entity Type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:R
Last Name:MEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:VANESSA
Other - Middle Name:R
Other - Last Name:MEZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:VANESSA MEZA
Mailing Address - Street 1:712 S WALDEMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4445
Mailing Address - Country:US
Mailing Address - Phone:509-521-1618
Mailing Address - Fax:
Practice Address - Street 1:712 S WALDEMAR AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4445
Practice Address - Country:US
Practice Address - Phone:509-521-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor