Individual
AMANDA SUE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
175 W B ST STE I, SPRINGFIELD, OR 97477-4575
(541) 988-1025
(541) 844-1051
Mailing address
PO BOX 1543, SPRINGFIELD, OR 97477-0167
(541) 988-1025
(541) 844-1051
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241382
—
OR
Enumeration date
07/22/2008
Last updated
07/22/2008
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