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Individual

RENEE GONZALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8304 NW 39TH EXPY, BETHANY, OK 73008-3011
(405) 787-4434
Mailing address
PO BOX 263, BETHANY, OK 73008-0263
(405) 787-4434

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1199
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1199
HEARING AID DEALER & FITTER LICENSE
OK
Enumeration date
09/29/2019
Last updated
09/29/2019
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