Provider Demographics
NPI:1952787368
Name:VASQUEZ-MCNAMARA, MARTA GEORGINA
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:GEORGINA
Last Name:VASQUEZ-MCNAMARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARTA
Other - Middle Name:GEORGINA
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 PEACEFUL MEADOWS DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-4073
Mailing Address - Country:US
Mailing Address - Phone:505-975-9853
Mailing Address - Fax:
Practice Address - Street 1:707 BROADWAY BLVD NE STE 500
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2367
Practice Address - Country:US
Practice Address - Phone:505-268-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health