Individual
JENNY R GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
500 HOSPITAL DR, CRESTVIEW, FL 32539-7355
(850) 698-4849
Mailing address
5760 HERMOSA CIR, PENSACOLA, FL 32526-2061
(904) 625-2698
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13206
FL
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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