Doctor Name: | MARJORIE GONZALEZ |
NPI Number: | 1194122143 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 114080 |
Business Practice Address: | 57 E Main St Ste 200 Westborough, MA - 015811457 |
Business Phone Number: | 5083660406 |
Business Fax Number: | |
Mailing Address: | 57 E Main St Ste 200, WESTBOROUGH |
State: | MA |
Postal Code: | 015811457 |
Phone Number: | 5083660406 |
Fax Number: | |
NPI Enumeration Date: | 11/19/2014 |
NPI Last Update Date: | 11/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 114080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |