Individual
MARISA KATHERINE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3610 N 44TH ST, PHOENIX, AZ 85018-6059
(602) 638-6661
Mailing address
128 W THUNDERBIRD RD, PHOENIX, AZ 85023-6248
(602) 638-6661
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15736
AZ
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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