Individual
MRS. MARISSA R GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1710 JET STREAM DR, COLORADO SPRINGS, CO 80921-3937
(719) 434-1109
Mailing address
3360 KNOLL LN APT 276, COLORADO SPRINGS, CO 80917-8516
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.00000X
CO
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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