Individual
MRS. REGINA J GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
1000 E. AZTEC AVENUE, EDUCATIONAL DEVELOPMENTAL CENTER, GALLUP, NM 87301
(505) 721-1819
Mailing address
PO BOX 1309, THOREAU, NM 87323-1309
(505) 721-1819
(505) 721-1899
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
B-05609
NM
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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