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Individual
MRS. JENNIFER GONZALEZ
Active
Individual
MRS. JENNIFER GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
106449
TX
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
3256
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCP036997
—
TX
Enumeration date
09/18/2014
Last updated
09/18/2014
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