Individual
ANAMARIE MIRANDA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4856
Mailing address
PSC 819 BOX 45, FPO, AE 09645-0001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C013997
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C013997
NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NC
Enumeration date
07/19/2019
Last updated
06/18/2021
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