Doctor Name: | HOLLY GONZALES |
NPI Number: | 1043230014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 18552 |
Business Practice Address: | 2323 W Front St Tyler, TX - 757027704 |
Business Phone Number: | 9035971351 |
Business Fax Number: | 9035357386 |
Mailing Address: | Po Box 4730, TYLER |
State: | TX |
Postal Code: | 757124730 |
Phone Number: | 9035971351 |
Fax Number: | 9035357386 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 06/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 18552 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |