Provider Demographics
NPI:1770329104
Name:VAZQUEZ TOVAR, ANNA
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:VAZQUEZ TOVAR
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:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-0129
Mailing Address - Country:US
Mailing Address - Phone:623-439-7472
Mailing Address - Fax:623-439-7349
Practice Address - Street 1:919 N DYSART RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1711
Practice Address - Country:US
Practice Address - Phone:623-439-7472
Practice Address - Fax:623-439-7349
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician