Individual
JENNIE LEE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
557 HEATHER GLEN DR, WINTER HAVEN, FL 33884-3275
(407) 417-0074
Mailing address
557 HEATHER GLEN DR, WINTER HAVEN, FL 33884-3275
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
G524432855871
FL
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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