Ivelisse Vazquez, MSW, LCSW

NPI #1033446562 in Roxbury, Massachusetts

Provider Information

NPI Number: 1033446562
Entity Type: Individual
Name: Ivelisse Vazquez, MSW, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: MSW, LCSW
Enumeration Date: Nov 4, 2009
Last Updated: Nov 4, 2009

Practice Location

Address: 55 DIMOCK ST
Address 2: ROOM 266A
City: Roxbury
State: Massachusetts
ZIP Code: 02119-1029
Phone: (617) 442-8800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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