Provider Demographics
NPI:1174155113
Name:VASQUEZ, RAQUEL C (PHD, LPC-S)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:C
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:MS
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:PACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1639 GUADALAJARA AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1937
Mailing Address - Country:US
Mailing Address - Phone:956-639-0033
Mailing Address - Fax:
Practice Address - Street 1:1639 GUADALAJARA AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-1937
Practice Address - Country:US
Practice Address - Phone:956-639-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health