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Individual

MICHELLE GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
Mailing address
6007 69TH ST, MASPETH, NY 11378-2936

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1044618161
NY
103TS0200X
School Psychologist
1045335161
NY

Other

Enumeration date
07/20/2016
Last updated
07/20/2016
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