Individual
MRS. AUDREY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.012116
IL
101YP2500X
Professional Counselor
2021046000
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.012116
DEPARTMENT OF PROFESSIONAL REGULATION
IL
01
—
2021046000
DEPARTMENT OF PROFESSIONAL REGULATION
MO
Enumeration date
03/27/2019
Last updated
08/03/2023
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