Provider Demographics
NPI:1912281775
Name:VAZQUEZ, GLORIAN TORRES (TO)
Entity Type:Individual
Prefix:
First Name:GLORIAN
Middle Name:TORRES
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:TO
Other - Prefix:MS
Other - First Name:GLORIAN
Other - Middle Name:TORRES
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TO
Mailing Address - Street 1:HC 4 BOX 2916
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9609
Mailing Address - Country:US
Mailing Address - Phone:787-949-1806
Mailing Address - Fax:
Practice Address - Street 1:CARR.719 KM1.0 INTERIOR BO HELECHAL
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-949-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical