Individual
IDALISSE MARIE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4972 AVE MILITAR, ISABELA, PR 00662-4163
(787) 365-0465
Mailing address
4972 AVE MILITAR, ISABELA, PR 00662-4163
(787) 365-0465
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
7545
PR
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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