Individual
BARBARA A GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
2208 MOLINE AVE, PUEBLO, CO 81003-3810
(719) 406-6487
Mailing address
2208 MOLINE AVE, PUEBLO, CO 81003-3810
(719) 406-6487
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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