Individual
JOANNE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2250 CHAPEL AVE W STE 100, CHERRY HILL, NJ 08002
(856) 482-9000
(856) 482-1159
Mailing address
2250 CHAPEL AVE W STE 100, CHERRY HILL, NJ 08002-2051
(856) 482-9000
(856) 482-1159
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00408500
NJ
103TC0700X
Clinical Psychologist
35SI00408500
NJ
103TS0200X
School Psychologist
35SI00408500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0491772
—
NJ
01
—
462971
MEDICARE
NJ
Enumeration date
08/04/2015
Last updated
08/08/2018
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