Individual
JULISSA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21505 N 78TH AVE STE 125, PEORIA, AZ 85382-3356
(602) 535-8341
Mailing address
4546 W SOLANO DR S, GLENDALE, AZ 85301-6242
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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