Doctor Name: | OLIVIA R. GONZALEZ |
NPI Number: | 1134213556 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 50 |
Business Practice Address: | 4110 Ave D Scottsbluff, NE - 69361 |
Business Phone Number: | 3086353171 |
Business Fax Number: | |
Mailing Address: | 560 Mark Dr., GERING |
State: | NE |
Postal Code: | 69341 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 50 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |