Provider Information for 1326371782
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Dr. JAMIELYNN GONZALES DSW, LCSW, FSW
Sex: Female
NPI: 1326371782
Last Updated: 2023-09-08
Certification Date: 2023-09-08
Certification Date: 2023-09-08
Details
| Name | Value | ||||||||||||||||
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| NPI | 1326371782 | ||||||||||||||||
| Enumeration Date | 2009-09-16 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 3736 EUBANK BLVD NE STE B1 ALBUQUERQUE, NM 87111-3583 United States Phone: 505-382-1578 | Fax:888-506-2110 | ||||||||||||||||
| Primary Practice Address | 3736 EUBANK BLVD NE STE B1 ALBUQUERQUE, NM 87111-3583 United States Phone: 505-382-1578 | Fax:888-506-2110 | ||||||||||||||||
| Secondary Practice Address(es) | 1005 21ST ST SE | ||||||||||||||||
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