Individual
JAMILEY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3786 E FELIX BLVD, TUCSON, AZ 85706-1926
(520) 406-5048
(520) 407-5398
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 407-5398
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10805029
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10805029
THERAPEUTIC FOSTER CARE
AZ
Enumeration date
03/31/2021
Last updated
03/31/2021
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