Individual
MRS. ALFREDA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 W HICKORY ST, EL DORADO SPRINGS, MO 64744-1402
(417) 876-6391
Mailing address
114 W HICKORY ST, EL DORADO SPRINGS, MO 64744-1402
(417) 876-6391
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2573-9130
MO
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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