Individual
IRENE JAZIL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
106 N ELM ST, GRANDVIEW, WA 98930-1009
(509) 402-9090
(866) 974-8679
Mailing address
106 N ELM ST, GRANDVIEW, WA 98930-1009
(150) 940-2909
(866) 974-8679
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61241782
WA
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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