Individual
ANTOINETTE GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACP
Contact information
Practice address
4 NESHAMINY INTERPLEX DR STE 202, TREVOSE, PA 19053-6940
(323) 829-1022
Mailing address
2517 DUNKSFERRY RD APT H104, BENSALEM, PA 19020-2734
(323) 829-1022
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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