Individual
DAVID MICHAEL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3223 W RICHWOODS BLVD, PEORIA, IL 61604-1082
(309) 685-5241
Mailing address
3223 W RICHWOODS BLVD, PEORIA, IL 61604-1082
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.013009
IL
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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