Individual
GIOVANI GONGORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 473-9253
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 473-9253
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14233604-3503
UT
Other
Enumeration date
01/12/2022
Last updated
07/23/2025
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