Individual
OLIVIA R. GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
4110 AVE D, SCOTTSBLUFF, NE 69361
(308) 635-3171
Mailing address
560 MARK DR., GERING, NE 69341
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
50
NE
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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