Provider Information for 1588196257
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LAUREN GONZALES
Sex: Female
NPI: 1588196257
Last Updated: 2020-01-22
Certification Date: 2020-01-22
Certification Date: 2020-01-22
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1588196257 | ||||||||
| Enumeration Date | 2017-03-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2534 LAVENDER ST NEW ORLEANS, LA 70122-2667 United States Phone: 714-519-5031 | Fax: | ||||||||
| Primary Practice Address | 615 BARONNE ST STE 304 NEW ORLEANS, LA 70113-1054 United States Phone: 504-814-8001 | Fax: | ||||||||
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