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Individual

LAURA LIDIA GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4646 S 3500 W STE 2, WEST HAVEN, UT 84401-9405
(801) 719-9410
Mailing address
2872 VIRGINIA WAY, OGDEN, UT 84403-0453

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10877209-3501
UT

Other

Enumeration date
02/26/2025
Last updated
02/26/2025
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