Provider Information for 1417342866
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SABRINA GONZALEZ LCSW
Sex: Female
NPI: 1417342866
Last Updated: 2015-06-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1417342866 | ||||||||
| Enumeration Date | 2015-04-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1559 BARTOW, FL 33831-1559 United States Phone: 863-519-0575 | Fax:863-582-9251 | ||||||||
| Primary Practice Address | 1239 E MAIN ST BARTOW, FL 33830-5058 United States Phone: 863-519-0575 | Fax:863-582-9251 | ||||||||
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