Individual
TERRI R GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., OTR, LMT
Contact information
Practice address
1501 E BUSTAMANTE ST STE G, LAREDO, TX 78041-8905
(956) 718-2020
Mailing address
2011 MUSSER ST, LAREDO, TX 78043-2357
(956) 727-7213
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
100590
TX
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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