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MRS. ETHEL GONZALEZ LCSW R

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1699836304

Individual Registrant:
MRS. ETHEL  GONZALEZ LCSW R
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3424 77TH ST APT#35 JACKSON HTS, NY 11372 US
Tel: 718-898-9615  Fax: --

Contact information for business:
3424 77TH ST APT#35 JACKSON HTS, NY 11372 US
Tel: 718-898-9615  Fax: --

Registration Information:
NPI: 1699836304
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
NYRO25697

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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