Individual
MANDIE LYNN BURGESS GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
396 S CENTRE ST, POTTSVILLE, PA 17901-3596
(570) 933-0072
(570) 516-9344
Mailing address
396 S CENTRE ST STE 3, POTTSVILLE, PA 17901-3597
(570) 933-0072
(570) 516-9344
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW143159
PA
225200000X
Physical Therapy Assistant
TE008109
PA
Other
Enumeration date
10/10/2008
Last updated
08/11/2025
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