Individual
JENNY LYNN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 ASHLEY HALL RD, CHARLESTON, SC 29407-3824
(774) 721-6452
(855) 504-4089
Mailing address
614 WATEREE DR, CHARLESTON, SC 29407-6635
(774) 721-6252
(855) 504-4089
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5538
SC
Other
Enumeration date
07/05/2023
Last updated
07/09/2023
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