Individual
MRS. IRAIDA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-4807
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-4807
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW01669
RI
174400000X
Specialist
3030637
MA
Other
Enumeration date
10/04/2006
Last updated
02/07/2017
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