| Doctor Name: | JESENIA GONZALEZ |
| NPI Number: | 1760635734 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 017141 |
| Business Practice Address: | 30 E 22nd St Huntington Station, NY - 117463210 |
| Business Phone Number: | 6312232112 |
| Business Fax Number: | |
| Mailing Address: | 30 East 22 Street, HUNTINGTON STATION |
| State: | NEW YORK |
| Postal Code: | 11746 |
| Phone Number: | 6312232112 |
| Fax Number: | |
| NPI Enumeration Date: | 11/03/2008 |
| NPI Last Update Date: | 11/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 017141 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| 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 |