Individual
JOHAN A GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
112 N BROAD ST, PHILA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
6832 N 9TH ST, PHILADELPHIA, PA 19126-2903
(267) 385-6073
(215) 634-7132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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