Individual
MS. MARIANTY MAVROS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
801 W BIG BEAVER RD, TROY, MI 48084-4726
(781) 725-6586
Mailing address
801 W BIG BEAVER RD STE 300, TROY, MI 48084-4725
(910) 556-9645
(248) 294-1150
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2212111333
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2364616
MA
Other
Enumeration date
11/18/2022
Last updated
05/29/2025
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