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Individual
MRS. CANDICE GONZALEZ
Active
Individual
MRS. CANDICE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6086447-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001404101
INTRMTN. HEALTH CARE
UT
01
—
262141
DESERET MUTUAL
UT
01
—
942938348
CHAMPUS
UT
01
—
942938348F
EDUCATORS MUTUAL
UT
Enumeration date
06/16/2006
Last updated
03/07/2023
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