Provider Demographics
NPI:1871293670
Name:VAZQUEZ RIOS, CRISTINA MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:VAZQUEZ RIOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CALLE 16
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3702
Mailing Address - Country:US
Mailing Address - Phone:787-436-4364
Mailing Address - Fax:
Practice Address - Street 1:BO. MARICAO SECT. BAJURA
Practice Address - Street 2:VEGA ALTA
Practice Address - City:PUERTO RICO
Practice Address - State:PR
Practice Address - Zip Code:00692-0069
Practice Address - Country:US
Practice Address - Phone:787-436-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical