Individual
TATIANA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1048 ASHLEY ST, BOWLING GREEN, KY 42103-2449
(270) 843-5300
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-309641
KY
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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