Individual
DR. TINA MARIE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
928 JAYMOR ROAD SUITE B-150, SOUTHAMPTON, PA 19040
(215) 584-0621
Mailing address
116 HOLLY DRIVE, HATBORO, PA 19040
(215) 584-0621
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018575
PA
Other
Enumeration date
09/01/2018
Last updated
09/01/2018
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