Individual
KRISTIN MICHELLE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3311 PACKERLAND DR STE A, DE PERE, WI 54115-9539
(920) 338-0100
(920) 338-0103
Mailing address
3311 PACKERLAND DR STE A, DE PERE, WI 54115-9539
(920) 338-0100
(920) 338-0103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2760-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568521334
INSURERS
WI
Enumeration date
12/07/2006
Last updated
06/26/2020
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