Doctor Name: | JULIA GONZALEZ |
NPI Number: | 1013389238 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 2019 Galisteo St Suite D-2 Santa Fe, NM - 875052143 |
Business Phone Number: | 5759735112 |
Business Fax Number: | |
Mailing Address: | 2491 Sawmill Rd Apt 1905, SANTA FE |
State: | NM |
Postal Code: | 875055680 |
Phone Number: | 5759735112 |
Fax Number: | |
NPI Enumeration Date: | 10/27/2015 |
NPI Last Update Date: | 10/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |