Provider Demographics
NPI:1033095542
Name:VAZQUEZ SOLIS, ANGIE JULIET
Entity type:Individual
Prefix:MISS
First Name:ANGIE
Middle Name:JULIET
Last Name:VAZQUEZ SOLIS
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:URB LOS MONTES
Mailing Address - Street 2:482 CALLE PALOMA
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-380-0258
Mailing Address - Fax:
Practice Address - Street 1:URB LOS MONTES
Practice Address - Street 2:482 CALLE PALOMA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-380-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8607103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling