Individual
FERMIN GONZALES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW, CCSS
Contact information
Practice address
9201 MONTGOMERY BLVD NE # 5, ALBUQUERQUE, NM 87111-2468
(505) 219-1919
Mailing address
9201 MONTGOMERY BLVD NE # 5, ALBUQUERQUE, NM 87111-2468
(505) 219-1919
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1105
NM
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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