Individual
BREANNA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3449 S. WRANGLER PL., ONTARIO, CA 91761
(909) 919-4901
Mailing address
3449 S. WRANGLER PL., ONTARIO, CA 91761-9188
(909) 919-4901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18791
CA
2355S0801X
Speech-Language Assistant
SP 3677
CA
Other
Enumeration date
09/01/2016
Last updated
06/11/2018
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