Doctor Name: | FRIDA GONZALEZ |
NPI Number: | 1124495841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 0175801 |
Business Practice Address: | 1007 N Pope St Silver City, NM - 880615161 |
Business Phone Number: | 5753881511 |
Business Fax Number: | 5755422388 |
Mailing Address: | 530 Demoss Street, LORDSBURG |
State: | NM |
Postal Code: | 880452618 |
Phone Number: | 5755428384 |
Fax Number: | 5755422388 |
NPI Enumeration Date: | 08/28/2015 |
NPI Last Update Date: | 08/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0175801 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |