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Individual

MRS. HANNAH GRACE GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT-BC

Contact information

Practice address
300 BROADWAY, LORAIN, OH 44052-1648
(440) 244-2200
Mailing address
253 1/2 E ERIE AVE APT 6, LORAIN, OH 44052-2050
(440) 787-8144

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
13396
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-5070894
INTERNATIONAL REVENUE SERVICE
OH
Enumeration date
12/03/2018
Last updated
12/03/2018
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