Individual
MIA L GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1751 WESLEY RD, AUBURN, IN 46706-3647
(260) 925-5494
Mailing address
103 1/2 E HIGH ST APT 3, HICKSVILLE, OH 43526-1181
(201) 248-1578
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007525A
IN
Other
Enumeration date
09/26/2021
Last updated
09/26/2021
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